Abstract
A high-dose (2g/kg) gammaglobulin (IVIG) treatment has been well established as a standard therapy for Kawasaki disease (KD). However, it has been clinically and economically expected to reduce a total dose of IVIG because the gammaglobulin is a blood preparation and very expensive. To assess the efficacy of a single infusion therapy of 1g/kg IVIG for preventing the cardiac sequelae, we attempted a multicentral prospective study using our own protocol. Method: 77 KD patients in the acute phase were randomly divided into 2 groups as follows: Group A, a single infusion of 2g/kg IVIG (an additional therapy: 2g/kg), Group B, a single infusion of 1g/kg IVIG (1st additional therapy: 1g/kg, and 2nd 2g/kg). The initial IVIG therapy was started in the 5-7th day of illness in all patients. The additional IVIG was performed in the cases who satisfied with 2 or more items of the following criteria at 24-36h after the first treatment: 1) body temperature >= 37.5 oC, 2) CRP >= 3.0g/dl, 3) neutrophils >= 7500/mm3. Serial echocardiograms were taken until 60 days of illness. Results: 36 were assigned to Group A and 41 to Group B. At enrollment the patients in each group had similar demographic characteristics and laboratory data before treatment. In Group A, no coronary arterial involvement was observed. In Group B, 2 patients with additional 2nd therapy showed temporary coronary dilatation (N.S. vs. Group A, X2 test). 32% in Group B patients were treated only with a single infusion of 1g/kg gammaglobulin. Conclusion: This prospective study suggests that a single infusion of 1g/kg gammaglobulin is clinically effective to prevent coronary sequelae as well as 2g/kg IVIG.
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Ozawa, SI., Sakata, K. & Hamaoka, K. Randomized-prospective Study of a Single Infusion of 1g/kg Gammaglobulin for Reducing a Total Dose of Gammaglobulin in Kawasaki Disease Treatment. Pediatr Res 53, 181 (2003). https://doi.org/10.1203/00006450-200301000-00163
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DOI: https://doi.org/10.1203/00006450-200301000-00163