Abstract
Purpose: Recently the clinical trials of steroid add-on therapy were reported with variable results in Kawasaki disease. We analyzed clinical outcome of high risk of patients with Kawasaki disease(≥ 4 points of Harada score) treated by 3 commonly used different treatment regimen with or without corticosteroids. Methods: Medical records of 96 children with Kawasaki disease treated with one of the 3 regimens were reviewed retrospectively. Regimen 1 was aspirin (100mg/kg/day) plus intravenous gamma globulin 2g/kg single dose; regimen 2, aspirin (100mg/kg/day) plus intravenous gamma globulin 1g/kg single dose; regimen 3, regimen 2 plus prednisolone (2mg/kg/day), followed by tapering 2weeks and pulse therapy of methyl prednisolone was performed in case of the retreatment. Also low dose aspirin was given in all 3 regimens for 8weeks after acute phase. The cardiovascular and laboratory evaluations were performed on acute phase, immediate after acute phase, and subacute phase, 8weeks after treatment. Results: The frequency of coronary artery lesions and laboratory findings in 3 different regimens were similar. The more rapid control of fever after treatment was noted in regimen 3. Furthermore the frequency of retreatment was decreased in regimen 3 compared to other 2 regimens. Conclusion: Steroid add-on therapy showed some beneficial outcome compared to conventional treatment regimens. The Role of steroid in the treatment of Kawasaki disease should be reassessed in systemic manner.
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Kang, SM., In, SM., Moon, EK. et al. Corticosteroids Add-on Therapy in the Acute Phase of Kawasaki Disease. Pediatr Res 53, 164 (2003). https://doi.org/10.1203/00006450-200301000-00064
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DOI: https://doi.org/10.1203/00006450-200301000-00064