All issues > Volume 43(5); 2000

Original Article

J Korean Pediatr Soc. 2000;43(5):658-666. Published online May 15, 2000.

Outcome of Cardiac Complication in Patients of Kawasaki Disease Treated with High-dose Gammaglobulin

Hyang-Sook HS Kim¹, Jong-Tae JT Kim², Ji-Yon JY Lee², Jo-Won JW Jung², Ki-Soo KS Pai²

¹Departments of Emergency Medicine, School of Medicine, Ajou University, Suwon, Korea
²Departments of Pediatrics, School of Medicine, Ajou University, Suwon, Korea

Correspondence Jo-Won JW Jung ,Email: jwjung@madang.ajou.ac.kr

Abstract

Purpose
: We performed the study to evaluate the risk factors associated with cardiac complication and the outcome of coronary lesions after high-dose(2g/kg, 1dose) gammaglobulin(IVIG) treatment in patients with Kawasaki disease(KD).
Methods
: Retrospective studies were performed on 338 cases of KD treated with high-dose IVIG at this hospital from May 1994 to March 1999.
Results
: Among 338 patients, fever was persistent for 8.09¡¾3.45 days in all patients and after IVIG infusion, fever subsided in 26.5¡¾26.4 hours. Forty-five patients(13.3%) with abnormal baseline echocardiogram remained febrile for 9.09¡¾4.09 days, significantly longer than normal baseline echocardiogram group. There was no significant differences in age, sex and other clinical findings. In 7 patients(2.1%) usage of medications above 12 months were needed. Eleven cases(3.3%) with persistent fever after their first course of IVIG therapy became afebrile post-second course of IVIG in 5 of the 11 cases with cardiac complication and in 1 case with recurrence. Twelve(male 11, female 1) of the 338 cases recurred after 8.45¡¾4.39 months. Three of those 12 cases had cardiac complication.
Conclusion
: The overall prevalence of persistent coronary abnormalities in KD patients treated with high-dose IVIG and aspirin remains low. Even if patients had cardiac complication, they improved later.

Keywords :Kawasaki disease, High-dose gammaglobulin therapy, Cardiac complication