Intravenous γ‐Globulin Treatment in Kawasaki Disease

@article{Harada1991IntravenousT,
  title={Intravenous $\gamma$‐Globulin Treatment in Kawasaki Disease},
  author={Kensuke Harada},
  journal={Pediatrics International},
  year={1991},
  volume={33}
}
  • K. Harada
  • Published 1 December 1991
  • Medicine
  • Pediatrics International
A multicenter randomized controlled study was carried out to assess the effectiveness of different, doses and kinds of γ‐globulin in Kawasaki disease. Gamma globulin lowered the incidence of coronary artery abnormalities. The effect of γ‐globulin was dose dependent. The intact type was more effective than the pepsin treated type. To establish the indications for γ‐globulin, a study was made of patients who received neither γ‐globulin nor indomethacin and who, within nine days of onset of… 
Predictors of coronary artery lesions after intravenous γ-globulin treatment in Kawasaki disease
TLDR
The introduction of IVGG therapy has improved the prognosis of Kawasaki disease, but approximately 10% of patients still develop CALs, and the need for more aggressive therapy in IVGG-resistant cases can be recognized early by increases in the WBC and neutrophil counts and serum CRP concentration after IVGG administration.
Prevalence of coronary artery abnormalities in Kawasaki disease is highly dependent on gamma globulin dose but independent of salicylate dose.
TLDR
It is concluded that 2 gm/kg IVGG combined with at least 30 to 50 mg/kg per day aspirin provides maximum protection against development of coronary abnormalities after KD.
Effects of Gamma-Globulin on the Cardiac Sequelae of Kawasaki Disease
TLDR
The effect of various factors, such as sex, age, serum albumin levels, and the timing of gamma-globulin (GG) therapy, on cardiac sequelae of Kawasaki disease were delineated.
A multicenter, randomized, controlled trial of intravenous gamma globulin therapy in children with acute Kawasaki disease
TLDR
It is concluded that five daily doses of 400 mg/kg of intravenous, polyethyleneglycol‐treated, human immunoglobulin and freeze‐dried, sulfonated human immunglobulin had clinically equivalent effects on coronary artery abnormalities, and that five weekly doses of 200mg/kg gamma globulin is more effective than that of 200 mg/ kg gamma Globulin.
Early intravenous gamma-globulin treatment for Kawasaki disease: the nationwide surveys in Japan.
TLDR
No evidence that IVGG treatment on day 4 or earlier has greater efficacy in preventing cardiac sequelae than treatment on days 5 to 9 is found, and there is also no evidence that early treatment increases the prevalence of cardiac sequelsae in a clinical practice setting.
Risk factors associated with the need for additional intravenous gamma‐globulin therapy for Kawasaki disease
TLDR
Investigating the characteristics of patients with Kawasaki disease who needed intravenous gamma‐globulin (IVGG) re‐treatment found that male sex, exanthema, and cervical lymphadenopathy were independent risk factors associated with the need for IVGG re‐ treatment.
A Clinical Study of Intravenous Gamma Globulin Re-treatment in Kawasaki Disease
TLDR
It was difficult to predict risk factors for IVGG re-treatment from these data, and it was appeared to be effective in the treatment of refractory KD, but could not reduce the incidence of coronary artery aneurysm.
Selective Gamma Globulin Treatment in Kawasaki Disease : The Comparison between Single 1g/kg and 2g/kg
TLDR
The therapeutic efficacy and clinical response of single IVGG 1g/kg therapy are parable to that of single 2g/ kg therapy for comparable risk group of Kawasaki disease.
Iv gamma globulin treatment of Kawasaki disease in Japan: results of a nationwide survey
TLDR
The proportion of those with cardiac sequelae was higher in patients who were treated with IVGG, possibly due to the fact that those who were more severely affected were more likely to be treated withIVGG.
Risk factors associated with the need for additional intravenous gamma-globulin therapy for Kawasaki disease.
TLDR
Male sex, recurrence, and treatment with IVGG at a dose of 1,000 mg/d or less within 4 d of illness onset are independent risk factors associated with the need for IVGG re-treatment.
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References

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The treatment of Kawasaki syndrome with intravenous gamma globulin.
TLDR
It is concluded that high-dose intravenous gamma globulin is safe and effective in reducing the prevalence of coronary-artery abnormalities when administered early in the course of Kawasaki syndrome.
Intravenous gamma-globulin for Kawasaki disease.
TLDR
It is demonstrated that when using IVGG for KD, patients should select a dose of intact gamma-globulin, 1,000 mg/kg or more in total, to prevent the occurrence of CAL.
Cost benefit of Kawasaki disease treatment. -Cost benefit of gamma-globulin treatment
  • Prog in Med
  • 1990