Manifestation of Coronary Artery Lesions after Immunoglobulin Re-treatment in Initial Immunoglobulin-resistant Kawasaki Disease / 소아과

PURPOSE: To evaluate the predictable factors for why initial intravenous immune globulin(IVIG) therapy failed and the outcome of coronary lesions after additional IVIG retreated in initial IVIG-resistant Kawasaki disease(KD). METHODS: Retrospective studies were performed on 284 cases of KD treated with one episode of high-dose IVIG and 63 cases with additional IVIG retreatment at this hospital from January 2000 to June 2003. 2D echocardiogram was done at admission, two months later and every two or three months when coronary lesion had improved more than two months later. RESULTS: In 69(24.3%) of 284 cases with post-first course of IVIG therapy, 19(43.2%) of 63 cases with additional IVIG retreatment, coronary abnormality had been shown by initial 2D-echocardiogram examined at acute stage. In five(1.8%) of 284 patients with post-first course of IVIG therapy, and in three(4.8%) of 63 cases with additional IVIG retreatment, coronary lesions still remained at follow-up echocardiogram. Even though there was a tendency of increased coronary lesions in the group with additional IVIG retreatment, there was no significant differences in the incidence of coronary lesions between the two groups. There were no significant differences in age, sex, and other clinical findings between the two groups. CONCLUSION: Combination therapy with high doses of IVIG and aspirin is generally effective as a standard treatment for KD but not always. Coronary lesion did not increased despite additional IVIG therapy for initial IVIG-resistant KD. There was no predictable factor for initial IVIG-resistant KD.

Study on the Restraining Factors in the Intravenous Immune Globulin(IVIG)Bacterial Endotoxin Test / 中国药房

OBJECTIVE:To study the restraining factors in the intravenous immune globulin(IVIG.)bacterial endotoxin test.METHODS:A series tests were designed;the sensitivity of limulus was checked and the limit of endotoxin was validated;the effects of vehicle and pH value on the IVIG endotoxin test results were observed so as to find out the chief restraining factors of this test method.RESULTS:Lower pH value has an inhibition effect on the in IVIG bacterial endotoxin test.CONCLUSION:Bacterial endotoxin test can replace the rabbit testing method in the pyrogen test of IVIG.When the condition of lower pH is changed.