Abstract:
objective:
To summarize the characteristics of Kawasaki disease(KD) patients with sterile pyuria and to investigate its value in predicting intravenous immunoglobulin(IVIG) unresponsive KD and coronary artery abnormalities(CAA) during acute phase.
Methods:
The records of 256 KD patients with adequate clinical data from February 2010 to May 2016 were retrospectively reviewed. The patients were assigned to non-sterile pyuria group（168 cases） and sterile pyuria group（88 cases）. Laboratory findings and clinical parameters were compared between the two groups. Cutoff value of urine leukocytes count for identifying IVIG-nonresponders was decided by ROC curve.
Results:
Sterile pyuria occurred in 88(34.4%) of the patients. The sterile pyuria group had longer duration of fever, higher average Kobayashi score(KS), higher proportion of children with a high KS(KS≥5) and were more often resistant to IVIG than the non-sterile pyuria group(P<0.05). The area under the ROC curve of urine leukocytes count was 0.699(95% CI: 0.580 to 0.798), with a sensitivity of 81.0% and a specificity of 52.2%. The best cut-off value for identifying IVIG-nonresponders was 27 leukocytes/μL. No statistical differences between the two groups in CAA occurrence were noted(P>0.05).
Conclusion:Sterile pyuria is a common feature of KD. Urine leukocytes count >27/μL might be useful in predicting non-responsiveness to IVIG, but not in predicting the development of CAA in children with KD.

Key words: Kawasaki disease;Sterile pyuria, IVIG unresponsive KD, Coronary artery abnormalities, Child