J Korean Pediatr Cardiol Soc.  2007 Jun;11(2):124-130.

Coronary Complication according to Retreatment of Immune Globulin in Kawasaki Disease

• Kim SE
• Oh JH
• Park SH
• Koh DK

Abstract

PURPOSE: Recently most of patients with Kawasaki disease (KD) get treatment within several days of illness. But, some patients still suffer from coronary complication (CC) despite early initial treatment with intravenous immune globulin (IVIG) and even the additional therapy. We investigated the risk factors of CC in non-responders to initial therapy who needed additional IVIG infusion among patients with KD.
METHODS
Forty five non-responders to initial IVIG who got additional IVIG infusion were reviewed from 1996 to 2007. We devided patients into two groups with CC (group A, n=17) or without CC (group B, n=28). Clinical characteristics, timing of additional IVIG infusion and laboratory results were reviewed. And we investigated the differences between the two groups and tried to find risk factors of CC.
RESULTS
In comparison between the two groups, CC, clinical characteristics and timing of IVIG infusion were not different between two groups. But, total febrile days were significantly longer and peak platelets counts were significantly higher in group A (P=0.006, P=0.013). On the logistic regression analysis, total febrile days longer than 10.5 days was the only risk factor of CC in these patients.
CONCLUSION
Our results showed that patients with CC inspite of repeated IVIG therapy had longer fever duration. So, additional therapy besides re-treatment with IVIG aiming at shortening total duration of fever seems to be important in refractory KD to prevent CC.

Keyword

Kawasaki disease; Coronary aneurysm; Non-responders; Re-treatment; Intravenous immune globulin

MeSH Terms

Coronary Aneurysm
Fever
Humans
Immunoglobulins, Intravenous
Logistic Models
Mucocutaneous Lymph Node Syndrome*
Retreatment*
Risk Factors
Immunoglobulins, Intravenous