| Corticosteroids Add-on Therapy in the Acute Phase of
Kawasaki Disease |
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Seon-Mi Kang1, Eun-Kyung Moon1, Su-Mi In2, Hong-Ryang Kil1 |
1Department of Pediatrics, College of Medicine, Chungnam National University, Daejon, Korea
2Department of Pediatrics, Sun Hospital*, Daejon, Korea |
| 고위험군 가와사끼병에서 스테로이드 추가 요법의 효과 |
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강선미1, 문은경1, 인수미2, 길홍량1 |
1충남대학교 의과대학 소아과학교실
2대전선병원 소아과 |
Correspondence:
Hong-Ryang Kil, Email: gilhong@medimail.co.kr
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| Abstract |
Purpose
: Recently, clinical trials of steroid add-on therapy were reported with variable results in Kawasaki disease. We analyzed the clinical outcomes of patients at high risk of with Kawasaki disease(≥4 points of Harada score) treated by three commonly used different treatment regimens, with or without corticosteroids.
Methods
: Medical records of 96 children with Kawasaki disease treated with one of the threee regimens were reviewed retrospectively. Regimen 1 was aspirin(100 mg/kg/day) plus intravenous gamma globulin 2 g/kg single dose; regimen 2, aspirin(100 mg/kg/day) plus intravenous gamma globulin 1 g/kg single dose; regimen 3, regimen 2 plus prednisolone(2 mg/kg/day), followed by tapering two weeks and pulse therapy of methyl prednisolone performed in cases of retreatment. Also low dose aspirin was given in all three regimens for eight weeks after the acute phase. The cardiovascular and laboratory evaluations were performed on acute phase, immediate after acute phase, and subacute phase, eight weeks after treatment.
Results
: The frequency of coronary artery lesions and laboratory findings in the three different regimens were similar. The more rapid control of fever after treatment was noted in regimen 3. Furthermore the frequency of retreatment was decreased in regimen 3 compared to the other two regimens.
Conclusion
: Steroid add-on therapy showed some beneficial outcome compared to conventional treatment regimens. The role of steroid in the treatment of Kawasaki disease should be reassessed in systemic manner. |
| Key Words:
Kawasaki disease, Steroid |
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