Efficacy of intravenous immune globulin therapy combined with dexamethasone for the initial treatment of acute Kawasaki disease |
| |
Authors: | Toshiaki Jibiki Masaru Terai Tomomichi Kurosaki Hiromichi Nakajima Kazuhiro Suzuki Hiroaki Inomata Itaru Terashima Takafumi Honda Kumi Yasukawa Hiromichi Hamada Yoichi Kohno |
| |
Affiliation: | (1) Department of Paediatrics, Chiba Municipal Kaihin Hospital, Chiba, Japan;(2) Department of Paediatrics, Graduate School of Medicine, Chiba University, 260-8670 Chiba, Japan;(3) Ichihara Hospital, Teikyo University School of Medicine, Ichihara, Japan |
| |
Abstract: | We studied the effects of a new regimen consisting of intravenous immune globulin (IVIG) combined with dexamethasone (DEX) on clinical outcome and serum levels of vascular endothelial growth factor (VEGF) in the initial treatment of Kawasaki disease (KD). A total of 46 KD patients received 0.3 mg/kg per day DEX plus heparin i.v. for 3 consecutive days, together with 2 g/kg IVIG over 4 to 5 days (DEX group). Low-dose acetylsalicylic acid was started after completion of DEX therapy. The control group consisted of 46 KD patients retrospectively treated earlier with 2 g/kg IVIG over 4 to 5 days plus higher dose acetylsalicylic acid (CONTROL group). No serious adverse effect was noted in either group. There were no differences in baseline and post-treatment laboratory data except for C-reactive protein between the groups. Post-treatment C-reactive protein in the DEX group (median 0.9 mg/dl, range 0.0 to 24.7 mg/dl) was lower than that (1.2 mg/dl, range 0.2 to 19.5 mg/dl) in the CONTROL group ( P =0.033 by Mann-Whitney U test). In addition, the mean duration of fever after the first IVIG infusion was 2.2 days (median 1 day, range 1 to 12 days) in the DEX group and 2.8 days (2 days, 1 to 16 days) in the CONTROL group ( P =0.015 by Mann-Whitney U test). The new regimen did not reduce VEGF levels. Two patients in each group developed small- or medium-sized coronary artery aneurysms. Conclusion:although this regimen did not affect coronary outcome, intravenous immune globulin therapy combined with dexamethasone for the initial treatment of Kawasaki disease was safe and may accelerate the resolution of systemic inflammation.Abbreviations CAA coronary artery aneurysms - DEX dexamethasone - IVIG intravenous immune globulin - KD Kawasaki disease - VEGF vascular endothelial growth factor |
| |
Keywords: | Coronary artery aneurysms Dexamethasone Intravenous immune globulin Kawasaki disease Vascular endothelial growth factor |
本文献已被 PubMed SpringerLink 等数据库收录! |
|