Abstract
We evaluated the efficacy of treating Kawasaki disease earlier than Day 5 of illness with a standard dose of immunoglobulin and aspirin. We performed a case–control study of patients with Kawasaki disease admitted to Princess Margaret Hospital from 1994 to 1999. Patients with pretreatment coronary aneurysm or those treated after day 10 of illness were excluded. All patients received immunoglobulin (2 g/kg) and aspirin (80–100 mg/kg/day) until fever subsided for 48 hours. Immunoglobulin retreatment was given for persistent fever 48 hours after the first dose of immunoglobulin or recrudescent fever. The case group consisted of 15 patients who received treatment earlier than day 5 of illness, and the control group consisted of 66 patients who were treated on or after day 5. Patients’ sex, age, duration of posttreatment fever, need for additional immunoglobulin, and coronary artery status were noted. Treatment efficacy was assessed by the duration of posttreatment fever and the prevalence of coronary artery aneurysms. Eighty-one patients were included in this study. There were 15 patients in the case group and 66 in the control group. No significant difference was noted in age and sex between the case and control groups. Thirty-three percent (5/15) and 8% (5/66) of the case and control groups, respectively, had persistent/ recrudescent fever 48 hours after the first dose of immunoglobulin that required retreatment (p = 0.017). Thirteen percent (2/15) and 5% (3/66) of the case and control groups, respectively, had coronary aneurysms (p = 0.158). Treatment of Kawasaki disease before day 5 of illness was associated with persistent/recrudescent fever that required retreatment. However, there was no significant increase in the prevalence of coronary aneurysm if retreatment was given.
Similar content being viewed by others
References
JC Burns EV Capparelli JA Brown et al. (1998) ArticleTitleIntravenous gamma-globulin treatment and retreatment in Kawasaki disease. Pediatr Infect Dis J 14 1144–1148 Occurrence Handle10.1097/00006454-199812000-00009
F Falcini M Ermini S Trapani et al. (1994) ArticleTitleEfficacy and safety of immunoglobulin retreatment in Kawasaki disease. J Pediatr 125 672–673 Occurrence Handle1:STN:280:ByqD3MjjsFw%3D
RK Han ED Silverman A Newman BW McCrindle (2000) ArticleTitleManagement and outcome of persistent or recurrent fever after initial intravenous gamma globulin therapy in acute Kawasaki disease. Arch Pediatr Adolesc Med 154 694–699 Occurrence Handle1:STN:280:DC%2BD3czlvVyhsw%3D%3D Occurrence Handle10891021
I Ichida NS Fatica MA Eagle et al. (1987) ArticleTitleCoronary artery involvement in Kawasaki syndrome in Manhattan, New York: risk factors and role of aspirin. Pediatrics 80 828–835 Occurrence Handle1:STN:280:BieD28jksVw%3D Occurrence Handle3684392
T Kawasaki (1967) ArticleTitleAcute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Jpn J Allergy 16 178–222 Occurrence Handle1:STN:280:CCeD2MnjsFw%3D
G Koren S Lavi V Rose R Rowe (1986) ArticleTitleKawasaki disease: review of risk factors for coronary aneurysms. J Pediatr 108 388–392 Occurrence Handle1:STN:280:BimC2czitVA%3D Occurrence Handle3950818
JW Newburger M Takahashi AS Beiser et al. (1991) ArticleTitleA single intravenous infusion of gamma globulin as compared with four infusions in the treatment of acute Kawasaki syndrome. N Engl J Med 324 1633–1639 Occurrence Handle1709446
JW Newburger M Takahashi JC Burns et al. (1986) ArticleTitleThe treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med 315 341–347 Occurrence Handle1:STN:280:BimB1cvosVM%3D Occurrence Handle2426590
RP Sundel TC Burns A Baker A Beiser (1993) ArticleTitleGamma globulin retreatment in Kawasaki disease. J Pediatr 123 657–659 Occurrence Handle8410524
SML Tse ED Silverman BW McCrindle RSM Yeung (2002) ArticleTitleEarly treatment with intravenous immunoglobulin in patients with Kawasaki disease. J Pediatr 140 450–455 Occurrence Handle10.1067/mpd.2002.122469 Occurrence Handle1:CAS:528:DC%2BD38XktlWgt7c%3D Occurrence Handle12006960
WA Wright JW Ñewburger A Baker RP Sundel (1996) ArticleTitleTreatment of immune globulin-resistant Kawasaki disease with pulsed doses of corticosteroid. J Pediatr 128 146–149 Occurrence Handle8551407
H Yanagawa Y Nakamura K Sakata M Yashiro (1997) ArticleTitleUse of intravenous gamma globulin for Kawasaki disease: effects on cardiac sequelae. Pediatr Cardiol 18 19–23 Occurrence Handle10.1007/s002469900102 Occurrence Handle1:STN:280:ByiC2sbms1w%3D Occurrence Handle8960487
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fong, N., Hui, Y., Li, C. et al. Evaluation of the Efficacy of Treatment of Kawasaki Disease before Day 5 of Illness . Pediatr Cardiol 25, 31–34 (2004). https://doi.org/10.1007/s00246-003-0558-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-003-0558-4