Early intravenous gamma-globulin treatment for Kawasaki disease: The nationwide surveys in Japan

Hiromi Muta, Masahiro Ishii, Kimiyasu Egami, Jun Furui, Yoko Sugahara, Teiji Akagi, Yoshikazu Nakamura, Hiroshi Yanagawa, Toyojiro Matsuishi

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Abstract

Objective: To determine the optimal period of intravenous gamma-globulin (IVGG) treatment, using the database from nationwide Kawasaki disease surveys in Japan. Study design: We selected patients who first visited a doctor within 3 days of illness and received IVGG treatment within 9 days of illness. We divided these patients into 2 groups: an early group (treated on days 1-4: 4731 cases) and a conventional group (days 5-9: 4020 cases). We compared the rate of additional IVGG and prevalence of cardiac sequelae between these groups. Results: The rate of additional IVGG in the early group was significantly higher than those of the conventional group (OR, 1.12 [95% CI, 1.10-1.16]). There were no significant differences in cardiac sequelae between the two groups. Conclusions: There is no evidence that IVGG treatment on day 4 or earlier has greater efficacy in preventing cardiac sequelae than treatment on days 5 to 9. In addition, early treatment is likely to result in a greater requirement for additional IVGG. However, there is also no evidence that early treatment increases the prevalence of cardiac sequelae in a clinical practice setting, where additional IVGG can be given to those whose initial treatment fails.

Original languageEnglish
Pages (from-to)496-499
Number of pages4
JournalJournal of Pediatrics
Volume144
Issue number4
DOIs
Publication statusPublished - Apr 2004
Externally publishedYes

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Muta, H., Ishii, M., Egami, K., Furui, J., Sugahara, Y., Akagi, T., Nakamura, Y., Yanagawa, H., & Matsuishi, T. (2004). Early intravenous gamma-globulin treatment for Kawasaki disease: The nationwide surveys in Japan. Journal of Pediatrics, 144(4), 496-499. https://doi.org/10.1016/j.jpeds.2003.12.033