Methylprednisolone Pulse Therapy or Additional IVIG for Patients with IVIG-Resistant Kawasaki Disease
| Autor: | Yanfei Wang, Feiyan Chen, Wei Li, Xiaofei Xie, Li Zhang, Ping Huang, Zhouping Wang, Xu Zhang, Peiying Liu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Article Subject Immunology Clinical Decision-Making Drug Resistance Drug resistance 030204 cardiovascular system & hematology Mucocutaneous Lymph Node Syndrome Group A Methylprednisolone Group B 03 medical and health sciences Young Adult 0302 clinical medicine Pharmacotherapy Internal medicine hemic and lymphatic diseases medicine Immunology and Allergy Humans 030212 general & internal medicine Young adult Child business.industry Incidence (epidemiology) Disease Management Immunoglobulins Intravenous General Medicine RC581-607 medicine.disease Clinical trial Treatment Outcome Child Preschool Kawasaki disease Drug Therapy Combination Female Immunologic diseases. Allergy business Biomarkers Research Article |
| Zdroj: | Journal of Immunology Research, Vol 2020 (2020) Journal of Immunology Research |
| ISSN: | 2314-8861 |
| DOI: | 10.1155/2020/4175821 |
| Popis: | There have been no robust data from clinical trials to guide the clinician in the choice of therapeutic agents for the child with intravenous immunoglobulin (IVIG) resistance. The treatment regimen for IVIG-resistant patients varies between institutions, and the best option has not yet been established. Therefore, in this trial, a total of 955 patients with Kawasaki disease (KD) were selected and were initially treated with IVIG (2 g/kg), of whom 80 (8.38%) assessed as IVIG resistant were randomly divided into two groups: Group A received the second IVIG treatment (n=40), and Group B received methylprednisolone pulse therapy (MPT,n=40). The whole fever time, duration of fever after retreatment, hospital days, medical costs, readmission rate, and laboratory examination difference (△) were calculated. Coronary artery lesion (CAL) outcomes were followed up over two years. Patients in the MPT group had shorter fever after retreatment and lower medical costs; more rapid declines in C-reactive protein (CRP), neutrophils (N%), and platelet (PLT) levels; and more rapid rise in sodium. However, they also probably had a higher incidence of treatment failure and CALs than the additional IVIG treatment group in the long-term follow-up. Caution is still required in the use of MPT to treat IVIG-resistant KD. |
| Databáze: | OpenAIRE |
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