The Kobayashi score is a clinical calculator used in the pediatric population, specifically for children diagnosed with Kawasaki disease. Kawasaki disease is an acute febrile illness of unknown cause that primarily affects children younger than 5 years of age. The disease is characterized by inflammation in the walls of medium-sized arteries throughout the body, including the coronary arteries.
The Kobayashi score is used to predict the likelihood of a child with Kawasaki disease being unresponsive to initial intravenous immunoglobulin (IVIG) therapy. IVIG is a treatment commonly used in Kawasaki disease to reduce inflammation and prevent coronary artery abnormalities. However, some children do not respond to the initial IVIG treatment and require additional therapies.
The score is calculated based on several clinical and laboratory parameters including age, days of illness, platelet count, levels of aspartate aminotransferase, sodium, and C-reactive protein. A higher score indicates a higher risk of IVIG resistance.
The Kobayashi score is not applicable to patients who have already received IVIG therapy or those with incomplete or atypical Kawasaki disease. It is also not recommended for use in populations outside of Japan without appropriate validation, as the score was developed and validated in a Japanese population.
Reference
Akihiko Nogami, Takashi Kurita, Haruhiko Abe et al. JCS / JHRS 2019 Guideline on Non-Pharmacotherapy of Cardiac Arrhythmias. Circ J. 2021 Jun 25;85(7):1104-1244.
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