[Effects of three intravenous gamma globulin regimens on Kawasaki disease and relevant coronary complication rates in pediatric patients: a comparative study].
OBJECTIVE
To compare the effects on Kawasaki disease (KD) of 3 different intravenous gamma globulin (IVIG) regimens and coronary complication rates in children with Kawasaki disease (KD).


METHODS
The clinical data of 1052 children with KD treated in 45 hospitals in Beijing from 2000 through 2004, 680 male and 372 female, aged 2 months-13.8 years, 656 (60.1%) undergoing IVIG 2 g/kg for one dose (single dose group), 292 (26.7%) undergoing 1 g.kg(-1).d(-1) for 2 days (2 d group), and 104 (9.5%) undergoing 400 - 600 mg.kg(-1).d(-1) for 4 - 5 d (4 - 5 d group) in addition of oral administration of aspirin, were analyzed retrospectively. Echocardiography was used to assess the occurrence of coronary complications 1 - 2 weeks after onset (acute stage) and 3 - 6 weeks after onset (sub-acute stage).


RESULTS
The rate of IVIG non-responder of the 2 d group was 20.9%, significantly higher than those of the single dose group and 4 - 5 d group (9.9% and 8.7% respectively, both P < 0.01). There were no significant differences in rates of coronary complication, pericardial effusion, and mitral regurgitation at the acute stage among the 3 groups (all P > 0.05). However, the rates of coronary complication and of coronary aneurysm at the sub-acute stage of the single dose group were 5.1% and 1.6%, significantly lower than those of the 4 - 5 d group (11.6% and 4.7%) and 2 d group (9.8% and 5.4%, P = 0.035 - 0.047) were significantly lower in single dose group (5.1% and 1.6%) as compared to those in 4 - 5 d group and (11.6% and 4.7%) and 2 d group (9.8% and 5.4%) (P = 0.035 - 0.047).


CONCLUSIONS
IVIG 2 g/kg in a single dose has lower rates of coronary complications and IVIG non-responders in children with KD, and is recommended for initial KD therapy.
DU
Zhong-Dong
ZD
Department of Cardiology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
Zhao
Di
D
DU
Jun-Bao
JB
Lu
Shan
S
Yi
Jing-Mei
JM
Hou
An-Cun
AC
Zhou
Zhong-Shu
ZS
Ding
Guo-Fang
GF
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000517:prevention & control; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D005719:gamma-Globulins / Q000008:administration & dosage / Q000627:therapeutic use*
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D005719:gamma-Globulins