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[Comparison of efficacy among early, conventional and late intravenous gamma globulin treatment of Kawasaki disease]. | LitMetric

[Comparison of efficacy among early, conventional and late intravenous gamma globulin treatment of Kawasaki disease].

Zhonghua Yi Xue Za Zhi

Beijing Kawasaki Disease Research Group, Department of Cardiology, Beijing Children's Hospital, Capital Medical University, Beijing 10045, China.

Published: July 2009

AI Article Synopsis

  • The study aimed to compare the effectiveness of intravenous gamma globulin (IVIG) treatment timing in children with Kawasaki disease, focusing on non-responder rates and coronary complications.
  • Data was collected from over 1,000 children treated at 45 hospitals in Beijing between 2000 and 2004, categorized into early, conventional, and late IVIG treatment groups based on the timing of administration.
  • Results indicated that early IVIG treatment increased the rate of non-responders, while treatment after Day 10 led to higher rates of coronary complications; optimal IVIG treatment seems to occur between Days 5 and 9.

Article Abstract

Objective: To compare the rates of intravenous gamma globulin (IVIG) non-responder and coronary complication among early, conventional and late IVIG treatment in children with Kawasaki disease (KD).

Methods: All children with KD and IVIG treatment were retrospectively analyzed at 45 hospitals in Beijing during the 5-year period from 2000 through 2004. The time of IVIG treatment was classified as early (Day 1 - 4), conventional (Day 5 - 9) and late treatment group (Day 10 or later). The efficacy of IVIG was judged by the rate of IVIG non-responder. Echocardiography was used to assess the coronary complication at acute (1 - 2 weeks after onset) and sub-acute (3 - 6 weeks after onset) stage.

Results: A total of 1052 patients (680 boys, 372 girls) aged 2 months to 13.8 years were included. They were grouped as early, conventional and late treatment in 108, 763 and 181 children respectively. The rate of IVIG non-responders was higher in early (28.7%, 31/108) as compared with conventional (11.9%, 91/763) and late treatment group (7.2%, 13/181, both P < 0.01). The incidences of coronary complications were similar in early (17.6%, 19/108 and 5.9%, 4/68) and conventional treatment group (18.3%, 140/ 763 and 5.5%, 25/452), while significantly higher in late treatment group (33.7%, 61/181 and 12.8%, 15/117) in acute and sub-acute stages (both P < 0.01).

Conclusions: IVIG treatment in children with KD for a disease duration of 1 - 4 days appeared to increase the rate of IVIG non-responders. Children with IVIG given at Day 10 or later had a higher incidence of acute and sub-acute coronary complications. IVIG given at Day 5 - 9 seems to be the best time for IVIG therapy in KD.

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