Efficacy of intravenous immune globulin therapy combined with dexamethasone for the initial treatment of acute Kawasaki disease
| Autor: | Yoichi Kohno, Hiromichi Nakajima, Hiroaki Inomata, Tomomichi Kurosaki, Toshiaki Jibiki, Kumi Yasukawa, I Terashima, Masaru Terai, Kazuhiro Suzuki, Takafumi Honda, Hiromichi Hamada |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Vascular Endothelial Growth Factor A medicine.medical_specialty medicine.drug_class Anti-Inflammatory Agents Mucocutaneous Lymph Node Syndrome Gastroenterology Dexamethasone Immunopathology Internal medicine medicine Humans Adverse effect biology Vascular disease business.industry C-reactive protein Immunoglobulins Intravenous Infant medicine.disease Surgery Regimen C-Reactive Protein Treatment Outcome Child Preschool Acute Disease Pediatrics Perinatology and Child Health biology.protein Corticosteroid Drug Therapy Combination Female Kawasaki disease business medicine.drug |
| Zdroj: | European Journal of Pediatrics. 163:229-233 |
| ISSN: | 1432-1076 0340-6199 |
| DOI: | 10.1007/s00431-003-1386-5 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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