The Effectiveness and Safety of Early Intravenous Immune Globulin Treatment for Kawasaki Disease

The diagnosis of Kawasaki disease (KD) is based on 5 characteristic clinical symptoms with fever persisting at least 5 days. Recently, early diagnosis and early intravenous immune globulin (IVIG) treatment are often reported. The aim of this study is to evaluate the effectiveness and safety of early IVIG treatment. One hundred thirty nine patients (pts.) were studied. The Harada's score was used to evaluate the severity of KD. In severe cases (Harada's score >3), pts. were administered high dose IVIG(2g/kg). In other cases (Harada's score <4), pts. were administered low dose IVIG (1g/kg). Group A, which was consisted of 77 pts. were received early IVIG treatment within 4 days. Group B, which was consisted of 62 pts., were received conventional IVIG treatment since 5 days. All patients were treated by 10days of illness. Twenty pts. in Group A(26%) and 13 patients in Group B(21%) were not clinical responders to the initial IVIG treatment (P=NS). No significant differences were found in incidence of coronary artery lesions between Group A (5/77, 6.5%) and Group B (5/62, 8.1%). The total duration of fever in early treatment group (Group A: 5.7±2.3days) was significantly shorter than that of conventional treatment group (Group B: 7.8±3.6days)(p<0.05). Conclusions: Early IVIG treatment was effective to improve KD symptoms earlier and didn't increase the complications of coronary artery lesions. The results in this study may demonstrate the merit of the further investigation of the KD as a source of baseline information for the design of future IVIG therapeutic protocols for KD.