Document Detail

Effects of methylprednisolone pulse on cytokine levels in Kawasaki disease patients unresponsive to intravenous immunoglobulin.
MedLine Citation:
PMID:  18175148     Owner:  NLM     Status:  MEDLINE    
This study aimed to determine the effects of intravenous methylprednisolone pulse (IVMP) therapy on cytokine levels in patients with acute Kawasaki disease (KD) unresponsive to initial intravenous immunoglobulin (IVIG) therapy. Fifteen KD patients unresponsive to initial IVIG, 2 g/kg/day, were randomized to receive IVMP (n = 7), 30 mg/kg/day for 3 days or additional IVIG (n = 8), 2 g/kg/day, and plasma cytokine levels were compared. The fraction of febrile patients was significantly lower in the IVMP group than in the additional IVIG group on day 2 (0/7 vs. 3/8, p = 0.03), but not on day 4 and later (3/7 vs. 4/8, p = 1.00) because of recurrent fever. The prevalence of coronary lesions was similar between the two groups (2/7 vs. 2/8, p = 1.00). The ratios of plasma levels of tumor necrosis factor-alpha and monocyte chemoattractant protein-1 to those at enrollment (defined as day 1) were significantly lower in the IVMP group on day 4 (0.50 +/- 0.27 vs. 1.01 +/- 0.46, 0.53 +/- 0.39 vs. 0.93 +/- 0.44, p = 0.02 and 0.045, respectively), but not on day 7 (0.54 +/- 0.34 vs. 0.88 +/- 0.39, 0.76 +/- 0.39 vs. 0.61 +/- 0.17, p = 0.07 and 0.83, respectively). The ratios of interleukin-2 receptor, interleukin-6, and vascular endothelial cell growth factor to those at enrollment did not differ significantly between the two groups. In conclusion, for KD patients unresponsive to initial IVIG, IVMP suppresses cytokine levels faster, but subsequently similarly, compared with additional IVIG.
Masaru Miura; Kazuki Kohno; Hirotaka Ohki; Shigeki Yoshiba; Akinori Sugaya; Masaaki Satoh
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2008-01-04
Journal Detail:
Title:  European journal of pediatrics     Volume:  167     ISSN:  1432-1076     ISO Abbreviation:  Eur. J. Pediatr.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-08-20     Completed Date:  2009-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603873     Medline TA:  Eur J Pediatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1119-23     Citation Subset:  IM    
Department of Cardiology, Tokyo Metropolitan Kiyose Children's Hospital, Tokyo, Japan.
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MeSH Terms
Acute Disease
Chemokine CCL2 / blood
Cytokines / blood*
Drug Resistance
Immunoglobulins, Intravenous / therapeutic use
Interleukin-6 / blood
Methylprednisolone / administration & dosage*
Mucocutaneous Lymph Node Syndrome / blood,  drug therapy*
Pulse Therapy, Drug
Receptors, Interleukin-2 / blood
Steroids / administration & dosage*
Tumor Necrosis Factor-alpha / blood
Vascular Endothelial Growth Factor A / blood
Reg. No./Substance:
0/Chemokine CCL2; 0/Cytokines; 0/Immunoglobulins, Intravenous; 0/Interleukin-6; 0/Receptors, Interleukin-2; 0/Steroids; 0/Tumor Necrosis Factor-alpha; 0/Vascular Endothelial Growth Factor A; 83-43-2/Methylprednisolone

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