| Evaluation of unresponsiveness to standard high-dose gamma globulin therapy in Kawasaki disease | |
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MedLine Citation:
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PMID: 20215838 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We investigated the incidence of unresponsiveness to intravenous gamma globulin (IVIG) treatment in Kawasaki disease (KD) and evaluated its relation with coronary artery involvement. STUDY DESIGN: The study included 20 children (13 boys, 7 girls; mean age 4.2+/-3.4 years; range 9 months to 12 years) with KD. The mean disease duration on admission was 7.3+/-2.4 days (range 5 to 14 days). Initial treatment consisted of a single dose of IVIG and high-dose of aspirin. Unresponsiveness was defined as the persistence of fever and other symptoms within the first 48 hours of treatment. All the patients were evaluated by two-dimensional echocardiography before and after treatment. The mean follow-up period was 16.5+/-2.8 months (range 9 to 24 months). RESULTS: Unresponsiveness was seen in five patients (25%), who received a subsequent dose of IVIG, which improved fever in two patients. The remaining three patients received high-dose methylprednisolone. One patient who showed no response to either IVIG or methylprednisolone was treated with low-dose oral methotrexate. Six patients (30%) had coronary artery involvement (4 dilatations, 2 aneurysms), five patients on admission echocardiography, and one patient on control echocardiography seven days after treatment. Of five unresponsive patients, four (80%) had coronary artery involvement on admission. Patients with coronary involvement underwent coronary angiography after a mean of one year. Five patients had normal coronary arteries, whereas no angiographic regression was observed in one patient who had a giant coronary artery aneurysm on admission and was treated with oral methotrexate. CONCLUSION: The incidence of unresponsiveness to treatment was markedly high in KD patients who had coronary artery involvement on admission. |
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Authors:
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Vedide Tavli; Murat Muhtar Yilmazer; Bari? G?ven; Timur Me?e; Taliha Oner; Sava? Demirpen?e |
Publication Detail:
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Type: English Abstract; Journal Article |
Journal Detail:
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Title: T?rk Kardiyoloji Derne?i ar?ivi : T?rk Kardiyoloji Derne?inin yay?n organ?d?r Volume: 38 ISSN: 1016-5169 ISO Abbreviation: Turk Kardiyol Dern Ars Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-03-10 Completed Date: 2010-06-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9426239 Medline TA: Turk Kardiyol Dern Ars Country: Turkey |
Other Details:
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Languages: tur Pagination: 20-4 Citation Subset: IM |
Affiliation:
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Department of Pediatric Cardiology, Beh?et Uz Children's Hospital, Izmir, Turkey. |
Vernacular Title:
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Kawasaki hastali?inda standart y?ksek doz intraven?z gama globulin tedavisine yanitsizli?in de?erlendirilmesi. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age of Onset Child Child, Preschool Coronary Angiography Coronary Disease / etiology, radiography Echocardiography Female Humans Immunoglobulins, Intravenous / therapeutic use* Male Methotrexate / therapeutic use Methylprednisolone / therapeutic use Mucocutaneous Lymph Node Syndrome / complications, drug therapy*, ultrasonography Treatment Failure Treatment Outcome gamma-Globulins / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Immunoglobulins, Intravenous; 0/gamma-Globulins; 59-05-2/Methotrexate; 83-43-2/Methylprednisolone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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