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Safety and Efficacy of Early Treatment with Intravenous Immunoglobulin in Patients with Kawasaki Disease

Journal of the Korean Pediatric Society 2003;46(10):1019-1023.
Published online October 15, 2003.
Safety and Efficacy of Early Treatment with Intravenous Immunoglobulin in Patients with Kawasaki Disease
Hyun Jin Kim, Hae Won Yom, Hae Soon Kim, Sejung Sohn
Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
가와사끼병에서 면역글로불린 조기치료의 안전성과 효과
김현진, 염혜원, 김혜순, 손세정
이화여자대학교 의과대학 소아과학교실
Correspondence: 
Hae Soon Kim, Email: hyesk@ewha.ac.kr
Abstract
Purpose
: To determine the differences in clinical characteristics, blood chemistry and coronary artery complications between patients with Kawasaki disease who received intravenous immunoglobulin (IVIG) within the fourth day of illness and after the fifth day of illness.
Methods
: A retrospective chart review was conducted of all children with Kawasaki disease who were admitted to Ewha Mokdong Hospital between January 2001 and June 2002. The early treatment group received IVIG within the fourth day of illness(n=34) and the control group received IVIG after the fifth day of illness(n=53). Clinical manifestations, fever duration, hospitalization days, CBC, blood chemistry and coronary artery complications were compared between two groups.
Results
: No demographic differences were noted between the two groups(P>0.05). Total duration of fever was significantly shorter in the early treatment group than the control group(4.8?.5 days vs 7.4?.0 days, P<0.05), but there were no differences in fever duration after IVIG treatment and hospitalization days between two groups(P>0.05). No significant differences were noted in the level of hemoglobin, WBC, ESR, CRP, AST, ALT and albumin between two groups(P>0.05). No significant differences in the incidence of IVIG retreatment were noted between the two groups(11.8% vs 5.7%, P>0.05). No significant differences in the incidence of coronary artery complications were noted between the two groups(11.7% vs 18.9%, P>0.05). No significant differences in the recurrence rate were noted between the two groups(3% vs 2%, P>0.05).
Conclusion
: Early IVIG treatment in patients with Kawasaki disease reduces the total fever duration. Coronary artery complications were not increased in patients with early IVIG treatment.
Key Words: Kawasaki disease, Intravenous immunoglobulin


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