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| J Pediatr. 2004 Apr;144(4):496-9. |
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Early intravenous gamma-globulin treatment for Kawasaki disease: the nationwide surveys in Japan.
Muta H, Ishii M, Egami K, Furui J, Sugahara Y, Akagi T, Nakamura Y, Yanagawa H, Matsuishi T.
Department of Pediatrics, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
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OBJECTIVE: To determine the optimal period of intravenous gamma-globulin (IVGG) treatment, using the database from nationwide Kawasaki disease surveys in Japan. STUDY DESIGN: We selected patients who first visited a doctor within 3 days of illness and received IVGG treatment within 9 days of illness. We divided these patients into 2 groups: an early group (treated on days 1-4: 4731 cases) and a conventional group (days 5-9: 4020 cases). We compared the rate of additional IVGG and prevalence of cardiac sequelae between these groups. RESULTS: The rate of additional IVGG in the early group was significantly higher than those of the conventional group (OR, 1.12 [95% CI, 1.10-1.16]). There were no significant differences in cardiac sequelae between the two groups. CONCLUSIONS: There is no evidence that IVGG treatment on day 4 or earlier has greater efficacy in preventing cardiac sequelae than treatment on days 5 to 9. In addition, early treatment is likely to result in a greater requirement for additional IVGG. However, there is also no evidence that early treatment increases the prevalence of cardiac sequelae in a clinical practice setting, where additional IVGG can be given to those whose initial treatment fails.
PMID: 15069399 [PubMed - indexed for MEDLINE]
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