{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:55:16Z","timestamp":1781769316948,"version":"3.54.5"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"DOI":"10.1007\/s00431-026-06931-5","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T03:45:44Z","timestamp":1780285544000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Higher IVIG resistance in Kawasaki disease patients treated early after fever onset: a single-center retrospective study of 2,988 cases"],"prefix":"10.1007","volume":"185","author":[{"given":"Jiahua","family":"Wen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujian","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofei","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhouping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"6931_CR1","first-page":"178","volume":"16","author":"T Kawasaki","year":"1967","unstructured":"Kawasaki T (1967) Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi = [allergy] 16:178\u2013222","journal-title":"Arerugi = [allergy]"},{"key":"6931_CR2","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1161\/01.CIR.94.6.1379","volume":"94","author":"H Kato","year":"1996","unstructured":"Kato H, Sugimura T, Akagi T et al (1996) Long-term consequences of kawasaki disease: a 10- to 21-year follow-up study of 594 patients. Circulation 94:1379\u20131385. https:\/\/doi.org\/10.1161\/01.CIR.94.6.1379","journal-title":"Circulation"},{"key":"6931_CR3","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/S0022-3476(05)80742-5","volume":"119","author":"KA Taubert","year":"1991","unstructured":"Taubert KA, Rowley AH, Shulman ST (1991) Nationwide survey of Kawasaki disease and acute rheumatic fever. J Pediatr 119:279\u2013282. https:\/\/doi.org\/10.1016\/S0022-3476(05)80742-5","journal-title":"J Pediatr"},{"key":"6931_CR4","doi-asserted-by":"publisher","first-page":"2747","DOI":"10.1161\/01.CIR.0000145143.19711.78","volume":"110","author":"JW Newburger","year":"2004","unstructured":"Newburger JW, Takahashi M, Gerber MA et al (2004) Diagnosis, treatment, and long-term management of kawasaki disease: A statement for health professionals from the committee on rheumatic fever, endocarditis and kawasaki disease, council on cardiovascular disease in the young, American heart association. Circulation 110:2747\u20132771. https:\/\/doi.org\/10.1161\/01.CIR.0000145143.19711.78","journal-title":"Circulation"},{"key":"6931_CR5","doi-asserted-by":"publisher","unstructured":"McCrindle BW, Rowley AH, Newburger JW, et al (2017) Diagnosis, treatment, and long-term management of kawasaki disease: A scientific statement for health professionals from the American heart association. Circulation 135. https:\/\/doi.org\/10.1161\/CIR.0000000000000484","DOI":"10.1161\/CIR.0000000000000484"},{"key":"6931_CR6","doi-asserted-by":"publisher","unstructured":"Jone P-N, Tremoulet A, Choueiter N, et al (2024) Update on diagnosis and management of kawasaki disease: A scientific statement from the American heart association. Circulation 150 https:\/\/doi.org\/10.1161\/CIR.0000000000001295","DOI":"10.1161\/CIR.0000000000001295"},{"key":"6931_CR7","doi-asserted-by":"publisher","first-page":"593435","DOI":"10.3389\/fped.2020.593435","volume":"8","author":"F Yan","year":"2020","unstructured":"Yan F, Zhang H, Xiong R et al (2020) Effect of early intravenous immunoglobulin therapy in kawasaki disease: A systematic review and meta-analysis. Front Pediatr 8:593435. https:\/\/doi.org\/10.3389\/fped.2020.593435","journal-title":"Front Pediatr"},{"key":"6931_CR8","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s13052-023-01451-6","volume":"49","author":"Z Li","year":"2023","unstructured":"Li Z, Cai J, Lu J et al (2023) The therapeutic window of intravenous immunoglobulin (IVIG) and its correlation with clinical outcomes in kawasaki disease: A systematic review and meta-analysis. Ital J Pediatr 49:45. https:\/\/doi.org\/10.1186\/s13052-023-01451-6","journal-title":"Ital J Pediatr"},{"key":"6931_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2021\/6660407","volume":"2021","author":"W Li","year":"2021","unstructured":"Li W, He X, Zhang L et al (2021) A retrospective cohort study of intravenous immunoglobulin therapy in the acute phase of kawasaki disease: The earlier, the better? Cardiovasc Ther 2021:1\u20137. https:\/\/doi.org\/10.1155\/2021\/6660407","journal-title":"Cardiovasc Ther"},{"key":"6931_CR10","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.jpeds.2003.12.033","volume":"144","author":"H Muta","year":"2004","unstructured":"Muta H, Ishii M, Egami K et al (2004) Early intravenous gamma-globulin treatment for kawasaki disease: the nationwide surveys in Japan. J Pediatr 144:496\u2013499. https:\/\/doi.org\/10.1016\/j.jpeds.2003.12.033","journal-title":"J Pediatr"},{"key":"6931_CR11","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.1093\/rheumatology\/keaa050","volume":"59","author":"X Jia","year":"2020","unstructured":"Jia X, Du X, Bie S et al (2020) What dose of aspirin should be used in the initial treatment of Kawasaki disease? A meta-analysis. Rheumatology 59:1826\u20131833. https:\/\/doi.org\/10.1093\/rheumatology\/keaa050","journal-title":"Rheumatology"},{"key":"6931_CR12","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.725126","volume":"12","author":"Y-H Huang","year":"2021","unstructured":"Huang Y-H, Hsin Y-C, Wang L-J et al (2021) Treatment of Kawasaki disease: a network meta-analysis of four dosage regimens of aspirin combined with recommended intravenous immunoglobulin. Front Pharmacol 12:725126. https:\/\/doi.org\/10.3389\/fphar.2021.725126","journal-title":"Front Pharmacol"},{"key":"6931_CR13","doi-asserted-by":"publisher","first-page":"1738","DOI":"10.1016\/j.jacc.2015.12.073","volume":"67","author":"JW Newburger","year":"2016","unstructured":"Newburger JW, Takahashi M, Burns JC (2016) Kawasaki disease. J Am Coll Cardiol 67:1738\u20131749. https:\/\/doi.org\/10.1016\/j.jacc.2015.12.073","journal-title":"J Am Coll Cardiol"},{"key":"6931_CR14","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1111\/ped.13809","volume":"61","author":"N Makino","year":"2019","unstructured":"Makino N, Nakamura Y, Yashiro M et al (2019) Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015\u20132016. Pediatr Int 61:397\u2013403. https:\/\/doi.org\/10.1111\/ped.13809","journal-title":"Pediatr Int"},{"key":"6931_CR15","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1097\/INF.0000000000002793","volume":"39","author":"GB Kim","year":"2020","unstructured":"Kim GB, Eun LY, Han JW et al (2020) Epidemiology of Kawasaki disease in South Korea: a nationwide survey 2015\u20132017. Pediatr Infect Dis J 39:1012\u20131016. https:\/\/doi.org\/10.1097\/INF.0000000000002793","journal-title":"Pediatr Infect Dis J"},{"key":"6931_CR16","doi-asserted-by":"publisher","first-page":"429","DOI":"10.2188\/jea.JE20190065","volume":"30","author":"L Xie","year":"2020","unstructured":"Xie L, Yan W, Huang M et al (2020) Epidemiologic features of Kawasaki disease in Shanghai from 2013 through 2017. J Epidemiol 30:429\u2013435. https:\/\/doi.org\/10.2188\/jea.JE20190065","journal-title":"J Epidemiol"},{"key":"6931_CR17","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.673554","volume":"9","author":"M Piram","year":"2021","unstructured":"Piram M (2021) Epidemiology of Kawasaki disease in Europe. Front Pediatr 9:673554. https:\/\/doi.org\/10.3389\/fped.2021.673554","journal-title":"Front Pediatr"},{"key":"6931_CR18","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1016\/S0022-3476(97)70038-6","volume":"131","author":"M Terai","year":"1997","unstructured":"Terai M, Shulman ST (1997) Prevalence of coronary artery abnormalities in Kawasaki disease is highly dependent on gamma globulin dose but independent of salicylate dose. J Pediatr 131:888\u2013893. https:\/\/doi.org\/10.1016\/S0022-3476(97)70038-6","journal-title":"J Pediatr"},{"key":"6931_CR19","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1542\/peds.96.6.1057","volume":"96","author":"K Durongpisitkul","year":"1995","unstructured":"Durongpisitkul K, Gururaj VJ, Park JM, Martin CF (1995) The prevention of coronary artery aneurysm in Kawasaki disease: a meta-analysis on the efficacy of aspirin and immunoglobulin treatment. Pediatrics 96:1057\u20131061. https:\/\/doi.org\/10.1542\/peds.96.6.1057","journal-title":"Pediatrics"},{"key":"6931_CR20","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00374","volume":"7","author":"F Yan","year":"2019","unstructured":"Yan F, Pan B, Sun H et al (2019) Risk factors of coronary artery abnormality in children with Kawasaki disease: a systematic review and meta-analysis. Front Pediatr 7:374. https:\/\/doi.org\/10.3389\/fped.2019.00374","journal-title":"Front Pediatr"},{"key":"6931_CR21","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.jpeds.2021.12.054","volume":"243","author":"D Van Stijn","year":"2022","unstructured":"Van Stijn D, Korbee JM, Netea SA et al (2022) Treatment and coronary artery aneurysm formation in kawasaki disease: A per-day risk analysis. J Pediatr 243:167-172.e1. https:\/\/doi.org\/10.1016\/j.jpeds.2021.12.054","journal-title":"J Pediatr"},{"key":"6931_CR22","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.5603\/KP.a2013.0180","volume":"71","author":"E Berdej-Szczot","year":"2013","unstructured":"Berdej-Szczot E, Firek-P\u0119dras M, Szyd\u0142owski L et al (2013) Analysis of risk factors and prospective evaluation of cardiovascular complications of kawasaki disease in children: a single centre study. Kardiol Pol 71:1279\u20131286. https:\/\/doi.org\/10.5603\/KP.a2013.0180","journal-title":"Kardiol Pol"},{"key":"6931_CR23","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1080\/00325481.2018.1468712","volume":"130","author":"H Qiu","year":"2018","unstructured":"Qiu H, He Y, Rong X et al (2018) Delayed intravenous immunoglobulin treatment increased the risk of coronary artery lesions in children with Kawasaki disease at different status. Postgrad Med 130:442\u2013447. https:\/\/doi.org\/10.1080\/00325481.2018.1468712","journal-title":"Postgrad Med"},{"key":"6931_CR24","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13142338","volume":"13","author":"P Nadig","year":"2023","unstructured":"Nadig P, Joshi V, Pilania R et al (2023) Intravenous immunoglobulin in Kawasaki disease\u2014evolution and pathogenic mechanisms. Diagnostics 13:2338. https:\/\/doi.org\/10.3390\/diagnostics13142338","journal-title":"Diagnostics"},{"key":"6931_CR25","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/ped.13512","volume":"60","author":"Y Shiozawa","year":"2018","unstructured":"Shiozawa Y, Inuzuka R, Shindo T et al (2018) Effect of i.v. immunoglobulin in the first 4 days of illness in Kawasaki disease. Pediatr Int 60:334\u2013341. https:\/\/doi.org\/10.1111\/ped.13512","journal-title":"Pediatr Int"},{"key":"6931_CR26","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1016\/j.ijcard.2018.07.092","volume":"269","author":"M Kuwabara","year":"2018","unstructured":"Kuwabara M, Yashiro M, Ae R et al (2018) The effects of early intravenous immunoglobulin therapy for Kawasaki disease: the 22nd nationwide survey in Japan. Int J Cardiol 269:334\u2013338. https:\/\/doi.org\/10.1016\/j.ijcard.2018.07.092","journal-title":"Int J Cardiol"},{"key":"6931_CR27","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1038\/pr.2015.12","volume":"77","author":"H Wakiguchi","year":"2015","unstructured":"Wakiguchi H, Hasegawa S, Suzuki Y et al (2015) Relationship between T-cell HLA-DR expression and intravenous immunoglobulin treatment response in Kawasaki disease. Pediatr Res 77:536\u2013540. https:\/\/doi.org\/10.1038\/pr.2015.12","journal-title":"Pediatr Res"},{"key":"6931_CR28","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1002\/art.37815","volume":"65","author":"Y Wang","year":"2013","unstructured":"Wang Y, Wang W, Gong F et al (2013) Evaluation of intravenous immunoglobulin resistance and coronary artery lesions in relation to Th1\/Th2 cytokine profiles in patients with Kawasaki disease. Arthritis Rheum 65:805\u2013814. https:\/\/doi.org\/10.1002\/art.37815","journal-title":"Arthritis Rheum"},{"key":"6931_CR29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0038998","volume":"7","author":"JM Orenstein","year":"2012","unstructured":"Orenstein JM, Shulman ST, Fox LM et al (2012) Three linked vasculopathic processes characterize Kawasaki disease: a light and transmission electron microscopic study. PLoS ONE 7:e38998. https:\/\/doi.org\/10.1371\/journal.pone.0038998","journal-title":"PLoS ONE"},{"key":"6931_CR30","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1097\/INF.0b013e318266bcf9","volume":"31","author":"SR Dominguez","year":"2012","unstructured":"Dominguez SR, Anderson MS, El-Adawy M, Glod\u00e9 MP (2012) Preventing coronary artery abnormalities: a need for earlier diagnosis and treatment of Kawasaki disease. Pediatr Infect Dis J 31:1217\u20131220. https:\/\/doi.org\/10.1097\/INF.0b013e318266bcf9","journal-title":"Pediatr Infect Dis J"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-026-06931-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-026-06931-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-026-06931-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:33:38Z","timestamp":1781768018000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-026-06931-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["6931"],"URL":"https:\/\/doi.org\/10.1007\/s00431-026-06931-5","relation":{},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]},"assertion":[{"value":"13 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 April 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The studies involving humans were approved by the Human Ethics Committee of Guangzhou Medical University Women and Children's Medical Center (Approval number: No. [2024]475A01). The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required from the participants or the participants\u2019 legal guardians\/next of kin in accordance with the national legislation and institutional requirements.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"452"}}