Table 1.
Clinical characteristics and laboratory investigation in KD patients with hemolytic anemia following IVIG
| Case 1 | Case 2 | Case 3 | Case 4 | |
|---|---|---|---|---|
| Gender | Male | Female | Male | Male |
| Age at diagnosis | 22 months | 4 years | 16 years | 7 months |
| Duration of fever before treatment | 13 days | 9 days | 8 days | 5 days |
| Clinical criteria of KD | 4/5 | 4/5 | 4/5 | 4/5 |
| Hemoglobin (g/L) before 1st IVIG | 94 (115-135) |
117 (115-155) |
114 (130-160) |
93 (105-135) |
| Lowest hemoglobin (g/L) after 2nd IVIG | 65 | 64 | 56 | 56 |
| Blood group | A Rh(D) pos | A Rh(D) pos | B Rh(D) pos | AB Rh(D) pos |
| Direct antiglobulin test baseline (IgG) | ND* | Negative | Negative | ND* |
| Direct antiglobulin test after hemolysis (IgG) | Positive | Positive | Positive | Positive |
| Antibody identified in red blood cell eluate | Anti-A | ND* | Anti-B | Anti-A, Anti-B |
| LDH (U/L) | 660 (470-920) |
522 (142-297) |
1881 (340-750) |
495 (140-304) |
| Indirect bilirubin (umol/L) | 12 (0-34) | 20 (0-34) | 55 (0-19) | 29 (0-34) |
| Haptoglobin (0.69 - 1.96 g/L) | 3.44 | ND* | 0.06 | 0.38 |
| Significant spherocytosis | Yes | Yes | Yes | Yes |
| Reticulocyte count (0.2 - 2%) | 13.1 | 12.2 | 4.7 | 2.4 |
| Blood transfusion | No | No | Yes | Yes |
| Coronary outcome | CAA | Normal | Normal | CAA |
ND* Not Done; CAA coronary artery aneurysm