Early intravenous gamma-globulin treatment for Kawasaki disease: the nationwide surveys in Japan.
OBJECTIVE
To determine the optimal period of intravenous gamma-globulin (IVGG) treatment, using the database from nationwide Kawasaki disease surveys in Japan.


METHODS
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.
Muta
Hiromi
H
Department of Pediatrics, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. QZE05346@nifty.com
Ishii
Masahiro
M
Egami
Kimiyasu
K
Furui
Jun
J
Sugahara
Yoko
Y
Akagi
Teiji
T
Nakamura
Yoshikazu
Y
Yanagawa
Hiroshi
H
Matsuishi
Toyojiro
T
D002675:Child, Preschool; D019992:Databases as Topic; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006306:Health Surveys; D006331:Heart Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D015995:Prevalence; D012737:Sex Factors
D016756:Immunoglobulins, Intravenous