• Title/Summary/Keyword: Intravenous immune globulin retreatment

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High-dose Intravenous Immune Globulin Retreatment in Kawasaki Disease (가와사끼병에서의 고용량 정주용 면역글로불린 재치료)

  • Shim, So Yun;Heo, Mi Young;Kim, Hae Soon;Sonh, Sejung
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1273-1277
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    • 2002
  • Purpose : To determine clinical features, laboratory findings and cardiac abnormalities of highdose immune globulin(IVIG) retreatment in patients with Kawasaki disease, and to report effectiveness of retreatment. Methods : Retrospective study of 174 children diagnosed with Kawasaki disease at Ewha Mokdong hospital from March, 1999 to July, 2001. Results : Twenty(11.5%) of 174 patients were retreated with high-dose IVIG. After this, only two patients(1.1%) did not respond to IVIG retreatment. Patients with failure to respond to initial IVIG did not differ from the patients who responded to a single course of IVIG in sex, age, days of fever at initial IVIG and clinical characteristics. Compared with responders with single IVIG treatment, the patients who were retreated had significantly lower albumin(3.7 vs 3.4 g/dL, P < 0.05), higher ALT(118.2 vs 229.3 U/L, P < 0.05) and CRP(8.9 vs 13.3 mg/dL, P < 0.05). On echocardiography, patients who recieved IVIG retreatment were significantly more likely to have caronary abnormalities(45.0% vs 13.6%, P < 0.05). Conclusion : Retratment with IVIG for persistent or recurrent fever was safe and effective.

The Clinical and Laboratory Features of Kawasaki Disease with Nonresponsibility to the Acute Antiinflammatory Treatment (급성기 항염치료에 반응하지 않은 가와사끼병의 임상양상과 검사소견)

  • Kim, Eun-Jung;Hong, Myung-Eun;Lee, Chang-Woo;Oh, Yeon-Geun;Kim, Jong-Duk;Yoon, Hyang-Suk
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.500-504
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    • 2003
  • Purpose : To assess the clinical features and laboratory findings in Kawasaki patients with nonresponsibility to the acute antiinflammatory treatment, and identify the risk factors for the nonresponsibility, we reviewed the medical records of patients with Kawasaki disease. Methods : A retrospective study of 177 patients with Kawasaki disease at Wonkwang University Medical Center from June, 1997 to June, 2002, was performed. High dose intravenous immune globulin(IVIG) and aspirin were all used for the initial acute antiinflammatory treatment. Two groups, group A(n=19) of initial nonresponders and group B(n=158) of initial responders were compared clinically and laboratorically. Results : Nineteen(10.7%) of 177 patients hardly responded to the initial antiinflammatory treatment. Patients with failure to respond to initial treatment(group A) did not differ from the control group in terms of age, sex, WBC count, coronary abnormalities, and evidence of pyuria. Compared with initial responders(group B), the patients who were retreated(group A) had a significantly shorter feveradmission interval(P=0.041), and a higher level of both AST/ALT(P=0.011) and ASO titier(P=0.000). Conclusion : Among Kawasaki disease patients studied, retreatment group with initial nonresponders had significantly shorter fever-admission interval, and higher both AST/ALT level and ASO titer, than the initial response group.