Comparative Study of Therapeutic Effect of Intravenous Gammaglobulin according to Administration Modality in Kawasaki Disease

Hwang, Jong Won; Huh, Jae Won; Chung, Hyun Kee

Abstract

PURPOSE
This study was designed for investigation of the differences in clinical manifestation, laboratory findings, effectiveness of treatment between intravenous gammaglobulin (IVGG) 400mg/kg/day for 5days (A) and 1g/kg/day for 2days (B) group in Kawasaki disease.
METHODS
A clinical observation and comparison of therapeutic effects were carried out on 11 patients (group A) and 30 patients (group B) of Kawasaki disease who were admitted to Kosin University Hospital from January 1993 to April 1996.
RESULTS
1) There were no significant difference in ages, sex ratios, durations of fever before treatment, and laboratory findings between two groups. 2) The duration of fever after onset of treatment were different significantly (group A, 2.63 1.06; group B, 1.26 0.63; p<0.01) The total duration of fever were different significantly (group A, 10 3.43; group B, 7.66 2.01; p<0.05) 3) In 2D-Echocardiography, coronary artery aneurysm were more frequent in group A (27.3%) than in group B (3.3%), it was significant difference (p<0.05) 4) The follow-up echocardiogram, 2 months later of IVGG administration, the result were as follows: i) Among 2 cases of mild coronary artery aneurysm, one was disappeared and the other was not followed. ii) 2 cases of giant coronary artery aneurysm were not improved. iii) All cases of coronary artery dilatation and pericardial effusion were disappered. ) Among 6 cases of moderate degree mitral and tricuspid regurgitation, 5 cases were improved and other 1 case was improved from grade 3/4 to grade 2/4.
CONCLUSIONS
We concluded that early combination therapy with high dose IVGG (1g/kg/day for 2days) is more effective than IVGG (400mg/kg/day for 5days) for prevention of coronary artery aneurysm development and for treatment of acute inflammation in Kawasaki disease.