Article in Japanese
Selected cases of Kawasaki disease can be treated with a single dose of gamma globulin at 1g/kg
Shiho YASUE1), Tomoaki HIRATE1)
There are few reports of treatment reduction in cases of low risk Kawasaki disease. This study evaluated 106 cases of Kawasaki disease treated at this hospital from June 2012 to May 2015. Cases at high risk for coronary artery abnormalities (Gunma score ≥ 5 points, age< 6 months, white blood cell count ≥ 15000/μL, C-reactive protein ≤ 12.0 mg/dL after day 8 of illness, and cardiac complications) received 2 g/kg of intravenous immunoglobulin (IVIG) plus prednisolone (PSL). The other cases received 1 g/kg of IVIG; first-day responders only received a single dose of 1 g/kg, and first-day non-responders received 1 g/kg of IVIG × 2 days. A total of 48 cases were treated with 1 g/kg of IVIG (group A), and 17 were treated with 1 g/kg of IVIG × 2 days (group B). Forty-one patients were treated with 2 g/kg of IVIG + PSL (group C). One case in group B and four cases in group C had cardiac disease, with persistent coronary artery aneurysms in 2 cases. There were no coronary aneurysms in group A. Some cases could be cured with a single dose of 1 g/kg of IVIG. It can be presumed that treatment reduction would be possible by excluding high-risk children.
1) Department of Pediatrics, Gifu Municipal Hospital
|Key words||Kawasaki disease, gamma globulin, 1g/kg, Gunma score|
|Received||July 24, 2018|
|Accepted||April 23, 2019|