Document Detail


Clinical responses of patients with Kawasaki disease to different brands of intravenous immunoglobulin.
MedLine Citation:
PMID:  16423595     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether different brands of intravenous immunoglobulin (IVIG) administered to children with Kawasaki disease (KD) result in different outcomes. STUDY DESIGN: We analyzed children with KD and divided them into 4 groups according to the brand of IVIG. A coronary artery abnormality (CAA) was defined as having a lumen diameter (inner border to inner border) of > or =3 mm in KD cases <5 years old and > or =4 mm in cases > or =5 years old, and giant aneurysm was defined as a lumen diameter > or =8 mm. Patients were considered nonresponsive to IVIG therapy if fever persisted longer than 2 days after completion of treatment and needed retreatment with IVIG. RESULTS: We collected 437 cases, 29 (6.6%) were nonresponsive, 17 (3.9%) had CAA at convalescence, and 3 (0.7%) had giant aneurysm, 2 of whom had development of myocardial infarcts. Patients receiving Brand C IVIG, prepared with beta-propiolactone, had higher rates (10%, 9/93, P = .01) of CAA at convalescence and nonresponsiveness (13%, 12/93, P = .001); giant aneurysm occurred in 3/93 (3%) receiving Brand C IVIG and in 0/344 who received the other 3 brands (P = .008). CONCLUSIONS: IVIG, prepared with beta-propiolactone, was most significantly associated with nonresponsiveness, CAA at convalescence, and giant aneurysm. Physicians should be cautious when using IVIG prepared with beta-propiolactone or enzyme digestion to treat KD.
Authors:
Ming-Han Tsai; Yhu-Chering Huang; Meng-Hsiu Yen; Chung-Chen Li; Cheng-Hsun Chiu; Pen-Yi Lin; Tzou-Yien Lin; Luan-Yin Chang
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  148     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-20     Completed Date:  2006-07-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  38-43     Citation Subset:  AIM; IM    
Affiliation:
Division of Pediatric Infectious Diseases, Division of Taipei Pediatrics, Department of Pediatrics, Chang-Gung Children's Hospital, Taoyuan, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Convalescence
Coronary Aneurysm / chemically induced
Female
Fever / chemically induced
Humans
Immunoglobulins, Intravenous / adverse effects,  therapeutic use*
Infant
Male
Mucocutaneous Lymph Node Syndrome / drug therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Immunoglobulins, Intravenous
Comments/Corrections
Comment In:
J Pediatr. 2006 Jan;148(1):6-8   [PMID:  16423589 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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