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Treatment of Intravenous Immune-Globulin Resistant Kawasaki Disease with Corticosteroids

Journal of the Korean Pediatric Society 1997;40(10):1453-1457.
Published online October 15, 1997.
Treatment of Intravenous Immune-Globulin Resistant Kawasaki Disease with Corticosteroids
Dae-Eui Hong, Kyung-Yil Lee, Ji-Whan Han, Sung-Soo Hwang, Kyong-Su Lee
Department of Pediatrics, Catholic University Medical College, Seoul, Korea
정맥용 면역글로불린에 반응하지 않는 가와사끼병에서의 코르티코스테로이드 치료
홍대의, 이경일, 한지환, 황성수, 이경수
가톨릭대학교 의과대학 소아과학교실
Abstract
Purpose
: To evaluate the efficacy of steroid therapy on prevention of development and progression of coronary artery aneurysm in intravenous immune globulin(IVIG)-resistant Kawasaki disease, we treated three children with high dose of intravenous methylprednisolone followed by low dose oral prednisolone.
Methods
: We selected three children with Kawasaki disease who did not repond or who initially responded but soon developed recrudescent fever after retreatment of IVIG(total 4gm/kg). These three patients were treated with high dose methylprednisolone(10mg/kg) intravenously and followed by low dose prednisolone(1mg/kg) orally for 7 days. Echocardiographic evalutions were performed within 8 days of admission (before steroid therapy), at discharge and 1 month after discharge.
Results
: All three patients showed rapid normalization of clinical symptoms and did not developed significant coronry artery abnormalities. No adverse reaction was observed.
Conclusions
: Steroid therapy(mini pulse methylprednisolone and prednisolone therapy) is valuable for patients with Kawasaki disease resistant to intravenous immune globulin therapy.
Key Words: Kawasaki disease, Methylprednisolone therapy, Intravenous immune globulin


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