All issues > Volume 43(11); 2000

Original Article

J Korean Pediatr Soc. 2000;43(11):1488-1494. Published online November 15, 2000.

Intravenous Gamma-globulin Retreatment in Kawasaki Disease

Young Ah YA Lee¹, Hyun Kee HK Chung¹

¹Department of Pediatrics, College of Medicine, Kosin University, Pusan, Korea
¹Department of Pediatrics, College of Medicine, Kosin University, Pusan, Korea

Abstract

Purpose
: This study was designed to determine the outcome and safety of intravenous gamma- globulin(IVGG) retreatment in Kawasaki disease.
Methods
: A clinical observation of the therapeutic effects, laboratory findings and echocardiograms was carried out on 72 patients with Kawasaki disease in Kosin University Hospital from 1991 to 1999. 27 patients were treated with 1g/kg/day IVGG for 2 days, 45 patients were treated with 2 g/kg for 10hours. The clinical indication for retreatment was fever. Persistent fever was defined as a temperature≥38.3℃ persisting beyond 48hrs after the completion of the infusion. Recrudescent fever was defined as a temperature≤38.3℃ for 48hrs after the completion of the infusion, followed by a temperature≥38.3℃. Treatment failure was defined as the development of new coronary artery abnormalities after IVGG treatment in a child with normal baseline echocardiogram.
Results
: The 5 patients(6.94%) were retreated with IVGG. Two were retreated due to persistent fever and three due to recrudescent fever. Among retreated patients, one was retreated with 1 g/kg and the others with 2g/kg. Nobody had serious complications, and there was no significantly different clinical charicteristics except for CRP between one course IVGG infusion and retreatment group(P=0.003). Treatment failure was not found in either group.
Conclusion
: We concluded that the IVGG retreatment of Kwasaki disease may improve the clinical course and coronary artery outcome.

Keywords :Kawasaki disease, Intravenous gamma-globulin retreatment