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Arthritis in the Subacute Stage of Kawasaki Disease after Responding to Intravenous Immunoglobulin Treatment

Journal of the Korean Pediatric Society 2003;46(11):1124-1127.
Published online November 15, 2003.
Arthritis in the Subacute Stage of Kawasaki Disease after Responding to Intravenous Immunoglobulin Treatment
Kyung-Yil Lee, Jin-Hee Oh, Dea-Kyun Koh
Department of Pediatric, College of Medicine, The Catholic University of Korea, Seoul, Korea
가와사끼병에서 정맥용 면역글로불린에 반응 후아급성기에 발생한 관절염
이경일, 오진희, 고대균
가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Kyung-Yil Lee, Email: leekyungyil@catholic ac.kr
Abstract
We evaluated the clinical and laboratory characteristics of five children with Kawasaki disease who had showed arthritis after responding to intravenous immunoglobulin(IVIG) treatment. Age distribution was between 13 months and six years of age(mean 3.2?.6 years). There were two males and three females. Arthritis occurred when acute symptoms were subsiding, with the average onset on day 5.8?.8 after final IVIG treatment. Arthritis was pauciarticular in three, and polyarticular in two. Regarding laboratory findings, one child was positive in rhematoid factor and changed to negative after two months. Three patients were examined for HLA B27 and all showed negative results. High dose aspirin(two cases), anti-inflammatory drug(ibprofen, three cases), and corticosteroids(methyprednisolon pulse therapy, one case) were used for this type of arthritis. Symptoms and signs of arthritis in all patients were improved by these therapies. There was no relapse or complications within six months. Arthritis after responding to IVIG therapy was rarely observed in children with Kawasaki disease. This type of arthritis responded well to anti-inflammatory drugs including corticosteroids, and showed no relapses.
Key Words: Kawasaki disease, Arthritis, Intravenous immunoglobulin


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