Intravenous γ-Globulin for Kawasaki Disease |
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| Authors: | Kenshi Furusho M.D. Tetsuro Kamiya M.D. Hiroyuki Nakano M.D. Nobuyuki Kiyosawa M.D. Keisuke Shinomiya M.D. Tadashi Hayashidera M.D. Tokio Tamura M.D. Osamu Hirose M.D. Yutaka Manabe M.D. Tatsuo Yokoyama M.D. Masaharu Kawarano M.D. Kunizo Baba M.D. Kiyoshi Baba M.D. Chuzo Mori M.D. Kunitaka Joho M.D. Shiro Seto M.D. |
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| Affiliation: | Department of Paediatrics, Kokura Memorial;Department of Paediatrics, Kyoto National;Department of Paediatrics, Mimihara General;Department of Paediatrics, Wakayama Red Cross;Department of Paediatrics, Kohga Public Hospitals;Department of Paediatrics, National Cardiovascular Centre;Department of Paediatrics, Kyoto Prefectural University of Medicine;Department of Paediatrics, Faculty of Medicine, Kyoto University;Department of Paediatrics, Heart Institute, Kurashiki Central Hospital;Department of Paediatrics, Shimane Medical University;Division of Paediatric Cardiology, Shizuoka Children's;Division of Paediatric Cardiology, Tenri;Division of Paediatric Cardiology, Kobe General;Division of Paediatric Cardiology, Kyushu Koseinenkin Hospitals;Division of Paediatric Cardiology, Osaka Medical Centre for Maternal and Child Health;Department of Paediatric Cardiology, Kinki University School of Medicine, Japan |
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| Abstract: | We studied the effect of γ-globulin (IVGG) and aspirin (ASA) on the development of the coronary artery lesions (CAL) of Kawasaki disease (KD) in three different protocols. Within 29 days of the onset of KD the echocardiographic evidence of CAL had developed in 39–42% of the patients in the ASA group, but only in 13.7–20.8% of the patients treated with IVGG (200 or 400 mgγkgX5). In long-term follow-up observation of CAL of these patients the evidence of CAL in both the ASA and the IVGG group regressed gradually; however, the residual rate of CAL was significantly low in the IVGG group at all times up to 24 months after onset. These facts suggest that when using IVGG for KD, we should select a dose of intact γ-globulin, 1,000 mgγkg or more in total, to prevent the occurrence of CAL. We have demonstrated not only a significant reduction in the occurrence of CAL in patients treated with IVGG but a reduction in the residual rate of CAL for two years as compared with those treated by ASA. |
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| Keywords: | Kawasaki disease γ-globulin therapy Coronary artery lesion |
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