title: Clinical responses of patients with Kawasaki disease to different brands of intravenous immunoglobulin.
abstract: OBJECTIVE
  To determine whether different brands of intravenous immunoglobulin (IVIG) administered to children with Kawasaki disease (KD) result in different outcomes.
  
  
  METHODS
  We analyzed children with KD and divided them into 4 groups according to the brand of IVIG. A coronary artery abnormality (CAA) was defined as having a lumen diameter (inner border to inner border) of > or =3 mm in KD cases <5 years old and > or =4 mm in cases > or =5 years old, and giant aneurysm was defined as a lumen diameter > or =8 mm. Patients were considered nonresponsive to IVIG therapy if fever persisted longer than 2 days after completion of treatment and needed retreatment with IVIG.
  
  
  RESULTS
  We collected 437 cases, 29 (6.6%) were nonresponsive, 17 (3.9%) had CAA at convalescence, and 3 (0.7%) had giant aneurysm, 2 of whom had development of myocardial infarcts. Patients receiving Brand C IVIG, prepared with beta-propiolactone, had higher rates (10%, 9/93, P = .01) of CAA at convalescence and nonresponsiveness (13%, 12/93, P = .001); giant aneurysm occurred in 3/93 (3%) receiving Brand C IVIG and in 0/344 who received the other 3 brands (P = .008).
  
  
  CONCLUSIONS
  IVIG, prepared with beta-propiolactone, was most significantly associated with nonresponsiveness, CAA at convalescence, and giant aneurysm. Physicians should be cautious when using IVIG prepared with beta-propiolactone or enzyme digestion to treat KD.
authors.affiliation: Division of Pediatric Infectious Diseases, Division of Taipei Pediatrics, Department of Pediatrics, Chang-Gung Children's Hospital, Taoyuan, Taiwan.
authors.forename: Ming-Han
authors.initials: MH
authors.lastname: Tsai
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
authors.forename: Meng-Hsiu
authors.initials: MH
authors.lastname: Yen
authors.forename: Chung-Chen
authors.initials: CC
authors.lastname: Li
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
authors.forename: Pen-Yi
authors.initials: PY
authors.lastname: Lin
authors.forename: Tzou-Yien
authors.initials: TY
authors.lastname: Lin
authors.forename: Luan-Yin
authors.initials: LY
authors.lastname: Chang
mesh_terms: D002648:Child; D002675:Child, Preschool; D003289:Convalescence; D003323:Coronary Aneurysm / Q000139:chemically induced; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous