Patients with Kawasaki disease (KD) who did not respond to the initial IVIG are known to have higher risk for developing coronary arterial lesions (CALs). Our aim is to clarify whether patients with initial IVIG resistant KD may benefit from methylprednisolone pulse therapy (MPT) in comparison with re- treatment of IVIG (2nd IVIG). A total of 237 patients (median age: 2 years 2 months; range 1 months–10 years) with KD were initially treated with IVIG (2 g/kg). Among them, 41 patients (22 %) were assessed as IVIG resistance: these patients were allocated to either group A receiving MPT (n = 14) or group B receiving the 2nd IVIG (n = 27). Patients with resistant to the additional therapy (MPT or 2nd IVIG) were received second IVIG (group A) or MPT (group B). Changes in leukocyte count, C-reactive protein and albumin before and after an additional therapy were significantly greater in group A than those in group B. However, the prevalence of CALs did not differ between the groups (36 % in group A and 26 % in group B, p > 0.05). There was no significant difference in the medical cost between the groups (median cost: 92,032 JPY in group A and 97,331 JPY in group B). MPT does not reduce the risk of development to CAL and does not seem to be beneficial as single agent therapy for IVIG resistant KD.
机构:
Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
Li, Wei
He, Xiufang
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Sun Yat Sen Univ, Affiliated Hosp 1, Dept Pediat Cardiovasc, Guangzhou 510080, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
He, Xiufang
Zhang, Li
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Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
Zhang, Li
Wang, Zhouping
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Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
Wang, Zhouping
Wang, Yanfei
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Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
Wang, Yanfei
Lin, Huimei
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Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Med Record, Guangzhou 510120, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
Lin, Huimei
Yuan, Jia
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Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
Yuan, Jia
Xie, Xiaofei
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Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
Xie, Xiaofei
Qin, Youzhen
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Sun Yat Sen Univ, Affiliated Hosp 1, Dept Pediat Cardiovasc, Guangzhou 510080, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
Qin, Youzhen
Huang, Ping
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Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R ChinaGuangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Cardiol, Guangzhou 510120, Peoples R China
机构:
Shaare Zedek Med Ctr, Pediat & Infect Dis Div, Jerusalem, Israel
Hebrew Univ Jerusalem, Fac Med, Jerusalem, IsraelShaare Zedek Med Ctr, Pediat & Infect Dis Div, Jerusalem, Israel
Bar-Meir, Maskit
Kalisky, Itai
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Shaare Zedek Med Ctr, Pediat & Infect Dis Div, Jerusalem, IsraelShaare Zedek Med Ctr, Pediat & Infect Dis Div, Jerusalem, Israel
Kalisky, Itai
Schwartz, Andrei
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Wolfson Med Ctr, Pediat & Pediat Infect Dis, Holon, IsraelShaare Zedek Med Ctr, Pediat & Infect Dis Div, Jerusalem, Israel
Schwartz, Andrei
Somekh, Eli
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Wolfson Med Ctr, Pediat & Pediat Infect Dis, Holon, Israel
Tel Aviv Univ, Sackler Sch Med, Tel Aviv, IsraelShaare Zedek Med Ctr, Pediat & Infect Dis Div, Jerusalem, Israel
Somekh, Eli
Tasher, Diana
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Wolfson Med Ctr, Pediat & Pediat Infect Dis, Holon, Israel
Tel Aviv Univ, Sackler Sch Med, Tel Aviv, IsraelShaare Zedek Med Ctr, Pediat & Infect Dis Div, Jerusalem, Israel