title: Initial intravenous gamma-globulin treatment failure in Iranian children with Kawasaki disease.
abstract: The purpose of this study was to determine the initial rates of intravenous gamma-globulin treatment (IVIG) failure in Kawasaki disease (KD) and their predisposing factors. This study was a retrospective analysis of the initial response to IVIG (2 g/kg), assessed from the medical reports of all patients admitted to Namazee Hospital pediatric ward, from March 1998 to March 2002, and who fulfilled the criteria for KD. Data were available for 64 patients, 58 of whom (90.6%) became afebrile 48 hours after completion of the initial dose of IVIG (Group I) and six (9.4%) who remained febrile (Group II). Two patients had a prompt response to a second dose of IVIG. In Group I, five patients (8.6%) developed coronary artery disease, seen on echocardiography. In Group II, two patients (33.3%) developed coronary artery disease. No significant difference was found in the prevalence of coronary artery disease between the two groups (p = 0.12), or in age or gender. The rate of initial treatment failure was 9.4% in this cohort of patients, which is comparable with previous reports. No predictive factors such as coronary artery disease, age or gender were found for initial treatment failure in KD.
authors.affiliation: Division of Immunology and Allergy, Pediatric Department, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Kashef
authors.forename: Mojgan
authors.initials: M
authors.lastname: Safari
authors.forename: Reza
authors.initials: R
authors.lastname: Amin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003327:Coronary Disease / Q000453:epidemiology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D016756:Immunoglobulins, Intravenous