High-dose Intravenous Immune Globulin Retreatment in Kawasaki Disease

ABSTRACT

PURPOSE: To determine clinical features, laboratory findings and cardiac abnormalities of high- dose immune globulin(IVIG) retreatment in patients with Kawasaki disease, and to report effectiveness of retreatment. METHODS: Retrospective study of 174 children diagnosed with Kawasaki disease at Ewha Mokdong hospital from March, 1999 to July, 2001. RESULTS: Twenty(11.5%) of 174 patients were retreated with high-dose IVIG. After this, only two patients(1.1%) did not respond to IVIG retreatment. Patients with failure to respond to initial IVIG did not differ from the patients who responded to a single course of IVIG in sex, age, days of fever at initial IVIG and clinical characteristics. Compared with responders with single IVIG treatment, the patients who were retreated had significantly lower albumin(3.7 vs 3.4 g/dL, P< 0.05), higher ALT(118.2 vs 229.3 U/L, P<0.05) and CRP(8.9 vs 13.3 mg/dL, P<0.05). On echocardiography, patients who recieved IVIG retreatment were significantly more likely to have caronary abnormalities(45.0% vs 13.6%, P<0.05). CONCLUSION: Retratment with IVIG for persistent or recurrent fever was safe and effective.