{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:28:17Z","timestamp":1793946497375,"version":"4.8.0"},"reference-count":36,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thelancet.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["eClinicalMedicine"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.eclinm.2026.103813","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:08:19Z","timestamp":1772608099000},"page":"103813","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Predictive value for intravenous immunoglobulin resistance of Kobayashi and Kawanet scores in 722 children with Kawasaki disease across diverse ethnic backgrounds (KIWI study): an international cohort study"],"prefix":"10.1016","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9784-3543","authenticated-orcid":false,"given":"Maria Vincenza","family":"Mastrolia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8490-5584","authenticated-orcid":false,"given":"Vignesh","family":"Pandiarajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7500-8838","authenticated-orcid":false,"given":"Marco","family":"Cattalini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Taddio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5893-3095","authenticated-orcid":false,"given":"Stefania","family":"Vergnano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Anton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6824-8788","authenticated-orcid":false,"given":"Watchareewan","family":"Sontichai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betul","family":"Sozeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2883-7868","authenticated-orcid":false,"given":"Seza","family":"Ozen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Rosina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"S\u00e1nchez-Manubens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruby","family":"Haviv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyankar","family":"Pal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana Rodrigues","family":"Fonseca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alenka","family":"Gagro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narendra Kumar","family":"Bagri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucio","family":"Verdoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Montin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Maggio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abarna","family":"Thangaraj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Pilania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Mosquera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Calzada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rekwan","family":"Sittiwangkul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kadir","family":"Ulu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep","family":"Balik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yelda","family":"Bilginer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Garrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Patrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Barbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Ciacci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3759-7512","authenticated-orcid":false,"given":"Andrea","family":"Barucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolino","family":"Ruperto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Simonini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"17","key":"10.1016\/j.eclinm.2026.103813_bib1","doi-asserted-by":"crossref","first-page":"e927","DOI":"10.1161\/CIR.0000000000000484","article-title":"Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American heart Association","volume":"135","author":"McCrindle","year":"2017","journal-title":"Circulation"},{"issue":"21","key":"10.1016\/j.eclinm.2026.103813_bib2","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1016\/j.jacc.2009.04.102","article-title":"When children with Kawasaki disease grow up: myocardial and vascular complications in adulthood","volume":"54","author":"Gordon","year":"2009","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"10.1016\/j.eclinm.2026.103813_bib3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.14740\/cr993","article-title":"Kawasaki disease: global burden and genetic background","volume":"11","author":"Elakabawi","year":"2020","journal-title":"Cardiol Res"},{"issue":"4","key":"10.1016\/j.eclinm.2026.103813_bib4","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1111\/ped.13809","article-title":"Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015-2016","volume":"61","author":"Makino","year":"2019","journal-title":"Pediatr Int"},{"key":"10.1016\/j.eclinm.2026.103813_bib5","doi-asserted-by":"crossref","first-page":"493","DOI":"10.3389\/fped.2020.00493","article-title":"Insights into coronary artery lesions in Kawasaki disease","volume":"8","author":"Zhang","year":"2020","journal-title":"Front Pediatr"},{"issue":"7","key":"10.1016\/j.eclinm.2026.103813_bib6","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1586\/1744666X.2015.1044980","article-title":"The immunomodulatory effects of intravenous immunoglobulin therapy in Kawasaki disease","volume":"11","author":"Burns","year":"2015","journal-title":"Expert Rev Clin Immunol"},{"key":"10.1016\/j.eclinm.2026.103813_bib7","first-page":"1","article-title":"Kawasaki disease: pathophysiology and insights from mouse models","author":"Noval Rivas","year":"2020","journal-title":"Nat Rev Rheumatol"},{"key":"10.1016\/j.eclinm.2026.103813_bib8","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jpeds.2006.03.050","article-title":"Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease","volume":"149","author":"Egami","year":"2006","journal-title":"J Pediatr"},{"key":"10.1016\/j.eclinm.2026.103813_bib9","doi-asserted-by":"crossref","first-page":"2606","DOI":"10.1161\/CIRCULATIONAHA.105.592865","article-title":"Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease","volume":"113","author":"Kobayashi","year":"2006","journal-title":"Circulation"},{"key":"10.1016\/j.eclinm.2026.103813_bib10","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/j.jpeds.2010.10.031","article-title":"Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance","volume":"158","author":"Sleeper","year":"2011","journal-title":"J Pediatr"},{"key":"10.1016\/j.eclinm.2026.103813_bib11","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1007\/s00296-016-3499-y","article-title":"Role of the Egami score to predict immunoglobulin resistance in Kawasaki disease among a Western Mediterranean population","volume":"36","author":"Sanchez-Manubens","year":"2016","journal-title":"Rheumatol Int"},{"key":"10.1016\/j.eclinm.2026.103813_bib12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0215665","article-title":"Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011\u20132016): KAWA-RACE study group","volume":"14","author":"Fernandez-Cooke","year":"2019","journal-title":"PLoS One"},{"key":"10.1016\/j.eclinm.2026.103813_bib13","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jpeds.2016.12.018","article-title":"Efficacy of four scoring systems in predicting intravenousimmunoglobulin resistance in children with Kawasaki disease in a children's Hospital in Beijing, North China","volume":"184","author":"Song","year":"2017","journal-title":"J Pediatr"},{"issue":"1","key":"10.1016\/j.eclinm.2026.103813_bib14","first-page":"25","article-title":"Prediction of resistance to intravenous immunoglobulin in children with Kawasaki disease","volume":"7","author":"Bar-Meir","year":"2018","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"1","key":"10.1016\/j.eclinm.2026.103813_bib15","doi-asserted-by":"crossref","first-page":"3125","DOI":"10.1038\/s41598-020-59972-7","article-title":"Defining the risk of first intravenous immunoglobulin unresponsiveness in non-Asian patients with Kawasaki disease","volume":"10","author":"Piram","year":"2020","journal-title":"Sci Rep"},{"issue":"2","key":"10.1016\/j.eclinm.2026.103813_bib16","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/INF.0b013e3181f386db","article-title":"External validation of a risk score to predict intravenous immunoglobulin resistance in patients with Kawasaki disease","volume":"30","author":"Seki","year":"2011","journal-title":"Pediatr Infect Dis J"},{"issue":"3","key":"10.1016\/j.eclinm.2026.103813_bib17","doi-asserted-by":"crossref","first-page":"216","DOI":"10.2188\/jea.JE20110126","article-title":"Epidemiologic features of Kawasaki disease in Japan: results of the 2009-2010 nationwide survey","volume":"22","author":"Nakamura","year":"2012","journal-title":"J Epidemiol"},{"issue":"3","key":"10.1016\/j.eclinm.2026.103813_bib18","doi-asserted-by":"crossref","first-page":"239","DOI":"10.2188\/jea.JE20140089","article-title":"Descriptive epidemiology of Kawasaki disease in Japan, 2011-2012: from the results of the 22nd nationwide survey","volume":"25","author":"Makino","year":"2015","journal-title":"J Epidemiol"},{"issue":"9","key":"10.1016\/j.eclinm.2026.103813_bib19","article-title":"Epidemiology of Kawasaki disease in Europe","volume":"9","author":"Piram","year":"2021","journal-title":"Front Pediatr"},{"issue":"3","key":"10.1016\/j.eclinm.2026.103813_bib20","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1038\/s41390-021-01459-w","article-title":"Comparison of IVIG resistance predictive models in Kawasaki disease","volume":"91","author":"Kaya Akca","year":"2022","journal-title":"Pediatr Res"},{"issue":"5","key":"10.1016\/j.eclinm.2026.103813_bib21","doi-asserted-by":"crossref","first-page":"e783","DOI":"10.1542\/peds.2008-1871","article-title":"Recognition of a Kawasaki disease shock syndrome","volume":"123","author":"Kanegaye","year":"2009","journal-title":"Pediatrics"},{"issue":"3","key":"10.1016\/j.eclinm.2026.103813_bib22","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s00431-012-1879-1","article-title":"Clinical manifestations associated with Kawasaki disease shock syndrome in Mexican children","volume":"172","author":"G\u00e1mez-Gonz\u00e1lez","year":"2013","journal-title":"Eur J Pediatr"},{"issue":"4","key":"10.1016\/j.eclinm.2026.103813_bib23","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/INF.0000000000002982","article-title":"Kawasaki disease and Kawasaki disease shock syndrome hospitalization rates in the United States, 2006-2018","volume":"40","author":"Maddox","year":"2021","journal-title":"Pediatr Infect Dis J"},{"issue":"1","key":"10.1016\/j.eclinm.2026.103813_bib24","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/INF.0000000000000010","article-title":"Epidemiologic features of Kawasaki disease in South Korea: data from nationwide survey, 2009-2011","volume":"33","author":"Kim","year":"2014","journal-title":"Pediatr Infect Dis J"},{"issue":"11","key":"10.1016\/j.eclinm.2026.103813_bib25","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1097\/INF.0000000000002793","article-title":"Epidemiology of Kawasaki disease in South Korea: a Nationwide Survey 2015-2017","volume":"39","author":"Kim","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"10.1016\/j.eclinm.2026.103813_bib26","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jpeds.2022.09.056","article-title":"Differences in the clinical characteristics of Kawasaki disease between older and younger children (2015-2019): a single-center, retrospective study","volume":"253","author":"Watanabe","year":"2023","journal-title":"J Pediatr"},{"key":"10.1016\/j.eclinm.2026.103813_bib27","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpeds.2023.02.001","article-title":"Clinical presentation and outcomes of Kawasaki disease in children from Latin America: a multicenter observational study from the REKAMLATINA network","volume":"263","author":"Narayan","year":"2023","journal-title":"J Pediatr"},{"issue":"6","key":"10.1016\/j.eclinm.2026.103813_bib28","doi-asserted-by":"crossref","first-page":"e1293","DOI":"10.1097\/MJT.0000000000000045","article-title":"Role of the Egami score in predicting intravenous immunoglobulin resistance in Kawasaki disease among different ethnicities","volume":"23","author":"Loomba","year":"2016","journal-title":"Am J Ther"},{"issue":"3","key":"10.1016\/j.eclinm.2026.103813_bib29","doi-asserted-by":"crossref","first-page":"349","DOI":"10.3390\/children12030349","article-title":"Macrophage activation syndrome in Kawasaki disease: insights from a systematic literature review on diagnosis, clinical features, and treatment","volume":"12","author":"Inguscio","year":"2025","journal-title":"Children"},{"issue":"4","key":"10.1016\/j.eclinm.2026.103813_bib30","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.semarthrit.2014.07.007","article-title":"Macrophage activation syndrome in Kawasaki disease: more common than we thought?","volume":"44","author":"Wang","year":"2015","journal-title":"Semin Arthritis Rheum"},{"issue":"23","key":"10.1016\/j.eclinm.2026.103813_bib31","doi-asserted-by":"crossref","first-page":"e481","DOI":"10.1161\/CIR.0000000000001295","article-title":"Update on diagnosis and management of Kawasaki disease: a scientific statement from the American Heart Association","volume":"150","author":"Jone","year":"2024","journal-title":"Circulation"},{"issue":"3","key":"10.1016\/j.eclinm.2026.103813_bib32","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1007\/s00431-018-3297-5","article-title":"Inability of Asian risk scoring systems to predict intravenous immunoglobulin resistance and coronary lesions in Kawasaki disease in an Italian cohort","volume":"178","author":"Fabi","year":"2019","journal-title":"Eur J Pediatr"},{"issue":"5","key":"10.1016\/j.eclinm.2026.103813_bib33","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2022-059175","article-title":"Prediction models for intravenous immunoglobulin resistance in Kawasaki disease: a meta-analysis","volume":"151","author":"Kuniyoshi","year":"2023","journal-title":"Pediatrics"},{"key":"10.1016\/j.eclinm.2026.103813_bib34","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2023.1164530","article-title":"Evaluation of Formosa score and diagnostic sensitivity and specificity of four Asian risk scores for predicting intravenous immunoglobulin resistance in Kawasaki disease: a bivariate meta-analysis","volume":"10","author":"Chiang","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"10.1016\/j.eclinm.2026.103813_bib35","article-title":"Development of a score for early identification of children with Kawasaki disease requiring second-line treatment in multi-ethnic populations in Europe: a multicentre retrospective cohort study","volume":"22","author":"Ouldali","year":"2022","journal-title":"Lancet Reg Health Eur"},{"issue":"3","key":"10.1016\/j.eclinm.2026.103813_bib36","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1038\/s41390-023-02519-z","article-title":"Intravenous immunoglobulin resistance in Kawasaki disease patients: prediction using clinical data","volume":"95","author":"Lam","year":"2024","journal-title":"Pediatr Res"}],"container-title":["eClinicalMedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S258953702600060X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S258953702600060X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T05:46:32Z","timestamp":1793943992000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S258953702600060X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":36,"alternative-id":["S258953702600060X"],"URL":"https:\/\/doi.org\/10.1016\/j.eclinm.2026.103813","relation":{},"ISSN":["2589-5370"],"issn-type":[{"value":"2589-5370","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Predictive value for intravenous immunoglobulin resistance of Kobayashi and Kawanet scores in 722 children with Kawasaki disease across diverse ethnic backgrounds (KIWI study): an international cohort study","name":"articletitle","label":"Article Title"},{"value":"eClinicalMedicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.eclinm.2026.103813","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"103813"}}