Risk factors associated with the need for additional intravenous gamma-globulin therapy for Kawasaki disease.
OBJECTIVE
To investigate the characteristics of patients with Kawasaki disease who needed intravenous gamma-globulin (IVGG) re-treatment.


METHODS
Using the database of the 17th nationwide survey in Japan, a total 11,366 patients were identified and analysed (1,855 re-treatment patients and 9,511 responders).


RESULTS
Multivariate logistic regression analysis showed that male sex (odds ratio (OR) 1.26; 95% CI 1.14-1.40), complete cases (OR 1.39; 95% CI 1.07-1.80), recurrence (OR 1.47; 95% CI 1.15-1.88), IVGG treatment within 4 d of illness (OR 2.05; 95% CI 1.84-2.27), daily dose of initial IVGG less than 1,000 mg/Kg (OR 0.54; 95% CI 0.48-0.61), exanthema (OR 2.03; 95% CI 1.62-2.56), lips and oral lesions (OR 1.57; 95% CI 1.24-1.98), peripheral extremities changes (OR 1.85; 95% CI 1.54-2.22), and cervical lymphadenopathy (OR 1.89; 95% CI 1.66-2.16) were independent risk factors associated with the need for IVGG re-treatment.


CONCLUSIONS
Male sex, recurrence, and treatment with IVGG at a dose of 1,000 mg/d or less within 4 d of illness onset are independent risk factors associated with the need for IVGG re-treatment.
Muta
Hiromi
H
Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan. qze05346@nifty.com
Ishii
Masahiro
M
Furui
Jun
J
Nakamura
Yosikazu
Y
Matsuishi
Toyojiro
T
D005076:Exanthema / Q000453:epidemiology; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D016756:Immunoglobulins, Intravenous; D007275:Injections, Intravenous; D016015:Logistic Models; D008206:Lymphatic Diseases / Q000453:epidemiology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000188:drug therapy* / Q000453:epidemiology; D012008:Recurrence; D012307:Risk Factors; D005719:gamma-Globulins / Q000008:administration & dosage / Q000627:therapeutic use*
D016756:Immunoglobulins, Intravenous; D005719:gamma-Globulins