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• W2016128426 abstract "OBJECTIVES: To determine if a shorter interval between Kawasaki Disease (KD) treatment with intravenous immunoglobulin (IVIG) and fever onset results in increased treatment failures, need for adjunctive therapy (ADJ) or development of coronary artery lesions (CAL). STUDY DESIGN: 178 KD patients diagnosed between 1987-1999 were included in this case-control study. All patients had fever plus > 4 out of the 5 clinical criteria for KD. Eighty-nine patients who received treatment at day 5 or earlier were matched to 89 patients treated at days 6-9 of fever according to the closest date of KD diagnosis to the index case. Compiled data from a detailed chart review included demographics, clinical features, fever duration, investigations, disease course and response to therapy. Differences between matched case and control pairs were analyzed using t-tests and McNemar tests. RESULTS: No demographical differences were noted between the 2 groups. Patients treated on 5 days of fever had a shorter total fever duration (5.2±1.9 days vs 8.0±1.8 days, p<0.0001), longer fever post IVIG treatment (1.5±1.9 days vs 0.8±1.3 days, p=0.008) and less coronary artery ectasia at 1 year post KD onset (4% vs 16%, p=0.02). There was no significant difference between cases and controls in the number of patients with KD recrudescence, need for repeat courses of IVIG, need for corticosteroids, length of hospitalization or development of coronary artery aneurysms within the first 3 months. Patients who were treated at day 5 of fever, had higher levels of serum albumin (36±5 g/L vs 33±5 g/L, p<0.01) and serum ALT (115±155 U/L vs 46±49 U/L, p<0.001), as well as a lower platelet count (354±131 vs 403±166, p=0.02) than controls during the acute phase. CONCLUSIONS: Early treatment of KD resulted in less coronary ectasia at one-year post KD onset but was not associated with a quicker resolution of fever, an increased number of treatment failures, an increased need for ADJ, length of hospitalization nor development of CAL. In children with fever and classical clinical and laboratory findings of KD, treatment with IVIG prior to 6 days of fever resulted in better coronary outcomes and decreased the length of time of clinical symptoms." @default.
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• W2016128426 date "2003-01-01" @default.
• W2016128426 modified "2023-09-22" @default.
• W2016128426 title "Early Treatment with Intravenous Immunoglobulin in Patients with Kawasaki Disease" @default.
• W2016128426 doi "https://doi.org/10.1203/00006450-200301000-00154" @default.
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