Abstract
Background. A meta-analysis which included six studies from Japan and U.S. showed that the prevalence of coronary abnormalities was inversely related to the total dose of intravenous immunoglobulin (IVIG). While most hospitals in Hong Kong followed the 2gm/kg IVIG treatment regime for Kawasaki disease, two hospitals adopted a flexible regime of using a starting dose of 1gm/kg IVIG followed by additional doses for persistence or recurrence of fever. This study compared the treatment effects of the two treatment regimes in terms of duration of fever and coronary complications. Method. A retrospective study of all Kawasaki disease patients admitted between 1 July 1994 to 30 June 1999 to 12 major hospitals in Hong Kong. Results. 146 patients were treated with the 1gm/kg flexible regime while 428 patients were in the 2g/kg group. There were no significant difference of the age distribution (median age: 1.58 years vs 1.59 years), sex ratio (62% boys in both groups) and the treatment starting date (5.2 vs 5.6 days after onset of fever). Whereas about 1/3 of the patients in both groups had rapid subsidence of fever within 12 hours, significantly more patients remained febrile after 48 hours in the 1 gm/kg IVIG group (24% vs 10%, p<0.001). The prevalence of coronary abnormalities at week 8 after the onset of disease was also higher in group 1 (11.6% vs 3.5%).Conclusion. 2gm/kg IVIG regime provides better protection against development of coronary abnormalities after Kawasaki disease than 1gm/kg IVIG flexible regime.
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Sung, R., So, L., Ng, Y. et al. Treatment of Kawasaki Disease with Intravenous Immunoglobulin: A Comparison of the 2GM/KG Regime with a 1 GM/KG Flexible Regime. Pediatr Res 53, 180 (2003). https://doi.org/10.1203/00006450-200301000-00162
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DOI: https://doi.org/10.1203/00006450-200301000-00162