title: Early intravenous gamma-globulin treatment for Kawasaki disease: the nationwide surveys in Japan.
abstract: 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.
authors.affiliation: Department of Pediatrics, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. QZE05346@nifty.com
authors.forename: Hiromi
authors.initials: H
authors.lastname: Muta
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ishii
authors.forename: Kimiyasu
authors.initials: K
authors.lastname: Egami
authors.forename: Jun
authors.initials: J
authors.lastname: Furui
authors.forename: Yoko
authors.initials: Y
authors.lastname: Sugahara
authors.forename: Teiji
authors.initials: T
authors.lastname: Akagi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yanagawa
authors.forename: Toyojiro
authors.initials: T
authors.lastname: Matsuishi
mesh_terms: 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
chemical_list: D016756:Immunoglobulins, Intravenous