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HK J Paediatr (New Series)
Vol 1. No. 2,
1996
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HK J Paediatr (New Series) 1996;1:211
Proceedings of Clinical Meeting
Intravenous Gammaglobulin and Outcome of Coronary Arteries in Kawasaki Disease
LY So LY So Department of Paediatrics, Prince of Wales Hospital, and The Chinese University of Hong Kong, Hong Kong
| HK J Paediatr (new series) 1996;1:207-220 The First Joint Scientific Meeting of Hong Kong College of Paediatricians and Guangdong Pediatric Society of the Chinese Medical Association
May 25, 1996 | Background Coronary artery aneurysms (CAA) still developed in some patients of Kawasaki disease when intravenous gammaglobulin (IVGG) was already a standard therapy. The present study attempt to identify factors associated with CAA and the outcome of patients treated with 2 different regimes. Methods 104 consecutive patients with Kawasaki disease were studied. 86 were given IVG& before 10 days of illness. Initially 40 patients (Group I) were given IVGG 400mg/kg/day for 4 or 5 days, subsequently 46 patients (Group II) were treated with IVGG lg/kg followed by additional doses when fever persisted or recurred. Bath groups of patients received aspirin 100mg/kg/day in the acute phase. Results Fever subsided early in about 70% and persisted for more than 4 days in 13% in both groups. Persistence of fever was associated with CAA formation in Group I. 6 out of 40 patients in group I had CAA. 26% of patients in Group II received more than lg/kg of IVGG when fever did not subside promptly. Only 1 out of 46 patients in group II had CAA and this was significantly less than those in group I (p<0.05). 7 out of 12 patients diagnosed after day 10 had CAA. Conclusions Giving a large single dose of IVGG followed by additional doses when required is a more economical and effective regime. A more flexible approach to cater for individual differences is beneficial.
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