ABSTRACT
Objective To study the dose of IVGG in treating atypical Kawasaki disease(KD) at defervescence and the necessity.Methods Clinical data of 54 cases of atypical Kawasaski disease without coronary artery lesion (CAL) but with the abatement of fever in 10 days were retrospectively analyzed. They were divided into there groups according to IVGG dosage ;group A (1g/kg IVGG n=11 ),group B(2g/kg n=24 ) and group C (blank n=19 ) .CAL was observed to at 14~21 days and 0.5year. Results Compared with group A and B, The rate of CAL was significantly higher (P0.05) . Conclusions In order to prevent CAL ,atypical Kawasaki disease(KD) children with confirmed diagnosis in 10 days should all be treated with IVGG whether with abatement of fever or not .The dose of 1g/kg IVGG would have satisfactory effects on atypical KD children at defervescence.
ABSTRACT
PURPOSE: Intravenous gamma globulin(IVGG) treatment has reduced symptoms and complications in Kawasaki disease(KD). However, fever persisted in 20-30% of the patients, and there are no reliable data on the indication and dosage of IVGG re-treatment. Therefore, we tried to reveal the effectiveness of IVGG re-treatment and to find risk factors in predicting the re-treatment. METHODS: Among 57 patients with typical KD, 47(82.5%) patients were put into group A, which improved after the treatment with standard 2g/kg of IVIG. 10(17.5%) patients were put into group B, which retreated with 1-2g/kg of IVIG due to persistent fever for at least 3 days after standard IVIG therapy. We compared clinical symptoms, laboratory findings and echocardiograms between group A and B, retrospectively. RESULTS: All patients in group B responded IVGG re-treatment and no considerable side effects. The total duration of the fever was significantly longer(P<0.001) and the initial and peak levels of CRP and the peak levels of ESR were significantly higher(P<0.01) in group B compared to group A. Even though leukocytosis, cervical lymphadenitis and coronary artery aneurysm were more frequent, and the levels of serum lipids at admission were lower in group B, without significance. CONCLUSION: IVGG re-treatment appeared to be effective in the treatment of refractory KD, but could not reduce the incidence of coronary artery aneurysm. We concluded it was difficult to predict risk factors for IVGG re-treatment from these data. Further studies are needed to determine the indication and appropriate dosage of IVGG re-treatment.
Subject(s)
Humans , Aneurysm , Coronary Vessels , Fever , gamma-Globulins , Immunoglobulins, Intravenous , Incidence , Leukocytosis , Lymphadenitis , Mucocutaneous Lymph Node Syndrome , Retrospective Studies , Risk FactorsABSTRACT
Dermatomyositis is an inflammatory muscular disease of presumed autoimmune origin. Many possible interventions are available to treat patients with these conditions including corticosteroids, immunosuppressive drugs, plasnapheresis, and total body irradiation. But these therapies are not always effective, and they may be associated with certain serious side effects. Recently polyvalent. intravenous gammaglohulin(IVGG) has been tried with success in inflammatory myopathies after failure of traditional treatment We report a 8-year-old female patient with juvenile dermatomyositis who improved dramatically after alternative IVGG treatment due to side effects of steroid.