Effect of Early Intravenous Immunoglobulin Therapy in Kawasaki Disease: A Systematic Review and Meta-Analysis
| Autor: | Furong Zhang, Yang Chen, Xingfeng Cheng, Hua-yong Zhang, Fan Yan, Ruihua Xiong |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Protective factor MEDLINE 030204 cardiovascular system & hematology Cochrane Library Pediatrics coronary artery lesion 03 medical and health sciences 0302 clinical medicine Intravenous Immunoglobulin Therapy 030225 pediatrics Internal medicine hemic and lymphatic diseases Medicine Stage (cooking) Coronary artery aneurysm Kawasaki disease business.industry lcsh:RJ1-570 lcsh:Pediatrics medicine.disease intravenous immunoglobulin therapy coronary artery aneurysm IVIG unresponsiveness Meta-analysis Pediatrics Perinatology and Child Health Systematic Review business |
| Zdroj: | Frontiers in Pediatrics Frontiers in Pediatrics, Vol 8 (2020) |
| ISSN: | 2296-2360 |
| DOI: | 10.3389/fped.2020.593435 |
| Popis: | Background:In the latest 2017 American Heart Association guidelines for Kawasaki disease (KD), there are no recommendations regarding the early administration of intravenous immunoglobulin (IVIG). Therefore, the purpose of this systematic review and meta-analysis was to investigate the effects of early IVIG therapy on KD.Methods:We searched databases including the PubMed, Medline, the Cochrane Library, and the Clinicaltrials.gov website until July 2019.Results:Fourteen studies involving a total of 70,396 patients were included. Early treatment with IVIG can lead to an increased risk of IVIG unresponsiveness [OR 2.24; 95% CI (1.76, 2.84);P= 0.000]. In contrast to the studies performed in Japan [OR 1.27; 95% CI (0.98, 1.64);P= 0.074] that found no significant difference in coronary artery lesions (CAL) development, studies conducted in China [OR 0.73; 95% CI (0.66, 0.80);P= 0.000] and the United States [OR 0.50; 95% CI (0.38, 0.66);P= 0.000] showed a reduced risk in the occurrence of CAL with early IVIG treatment.Conclusions:At present, the evidence does not support the treatment with IVIG in the early stage of the onset of KD. But, early IVIG treatment could be a protective factor against the development of CAL, which needs to be further clarified. |
| Databáze: | OpenAIRE |
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