The treatment of Kawasaki syndrome with intravenous gamma globulin.
We compared the efficacy of intravenous gamma globulin plus aspirin with that of aspirin alone in reducing the frequency of coronary-artery abnormalities in children with acute Kawasaki syndrome in a multicenter, randomized trial. Children randomly assigned to the gamma globulin group received intravenous gamma globulin, 400 mg per kilogram of body weight per day, for four consecutive days; both treatment groups received aspirin, 100 mg per kilogram per day, through the 14th day of illness, then 3 to 5 mg per kilogram per day. Two-dimensional echocardiograms were interpreted blindly and independently by two or more readers. Two weeks after enrollment, coronary-artery abnormalities were present in 18 of 78 children (23 percent) in the aspirin group, as compared with 6 of 75 (8 percent) in the gamma globulin group (P = 0.01). Seven weeks after enrollment, abnormalities were present in 14 of 79 children (18 percent) in the aspirin group and in 3 of 79 (4 percent) in the gamma globulin group (P = 0.005). No child had serious adverse effects from receiving gamma globulin. We conclude that high-dose intravenous gamma globulin is safe and effective in reducing the prevalence of coronary-artery abnormalities when administered early in the course of Kawasaki syndrome.
D000783:Aneurysm / Q000517:prevention & control; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000628:therapy*; D011897:Random Allocation; D005719:gamma-Globulins / Q000008:administration & dosage* / Q000009:adverse effects
D005719:gamma-Globulins; D001241:Aspirin