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Treatment of Kawasaki Disease with Single High-dose Intravenous Gammaglobulin

Journal of the Korean Pediatric Society 1992;35(3):342-348.
Published online March 15, 1992.
Treatment of Kawasaki Disease with Single High-dose Intravenous Gammaglobulin
Mi Koo Kang, Eun Young Cho, Young Hwue Kim, Ki Soo Kim, Young Seo Park, In Sook Park, Hyung Nam Moon, Chang Yee Hong
Department of Pediatrics, College of Medicine, Ulsan University, Seoul, Korea
가와사끼병에 대한 대량 감마글로불린 1회 저맥주사의 치료효과
강미구, 조은영, 김영휘, 김기수, 박영서, 박인숙, 문형남, 홍창의
울산대학교 의과대학 소아과학교실
Kawasaki disease is an acute febrile illness of unknown origin and most frequently affects infants and children under 5 years of age. Coronary aneurysms are the most serious complications and 15-20% of patient develop coronary aneurysm. We studied 50 children who wre diagnosed as Kawasaki disease and treated simultaneously with single high-dose gammaglobulin (2 gm/kg/day) and aspirin at Asan Medical Canter from June 1989 to February 1991. The clinical and echocardiographic findings were as follows 1) The ratio of male to female was 1.3:1. 2) The mean age was 22.3 months and the ranges ws 4 months to 7 years old. 3) All patients had high fever and the mean duration of fever was 5.5 days. 4) Other clinical finding were conjunctival injection (94%), amorphous skin rash (88%), oropharyngeal mucosa change (88%), extremity change (74%) and cervical lymphadenopathy (64%). 5) After intravenous gammaglobulin infusion, fever and other clinical findings subsided within 24 hours in 42 patients (84%) and mean fever duration was 1.4 days in 50 patients. 6) During single high-dose gammaglobulin infusion, the side effects such as high spiking fever, chillness, pallor, skin rash, dyspnea wre developed, but gammaglobulin could be infused without problem. 7) In ehocardiographic findings, mild dilatation of coronary arteries were noted in 12 case (24.0%) at 20 days after the onset. But 2 month after the onset, echocardiographic findings were normal in all patients. 8) We concluded that single high-dose intravenous gammaglobulin is safe and effective in reducing the fever and other clinical findings and reducing the prevalence of coronary artery abnormalities. Therefore we recommended that all children in acute phase of Kawasaki disease receive single high-dose intravenous gammaglobulin as soon as possible.
Key Words: Kawasaki disease, Single high-dose intravenous gammaglobulin

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