Late intravenous gamma globulin treatment in infants and children with Kawasaki disease and coronary artery abnormalities

Marasini, Maurizio; Pongiglione, Giacomo; Gazzolo, Diego; Campelli, A; Ribaldone, D; Caponnetto, S

doi:10.1016/0002-9149(91)90658-8

Cited by 61 publications

(20 citation statements)

References 10 publications

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“…Treatment of Kawasaki disease before day 5 of illness appears no more likely to prevent cardiac sequelae than does treatment on days 5 to 7, but it may be associated with an increased need for IVIG retreatment. 150,151 IVIG also should be administered to children presenting after the 10th day of illness (ie, children in whom the diagnosis was missed earlier) if they have either persistent fever without other explanation 152 or aneurysms and ongoing systemic inflammation, as manifested by elevated ESR or CRP (evidence level C).…”

Section: Ivigmentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Pediatrics

1,697

2,533

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ABSTRACT. Background. Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in ϳ15% to 25% of untreated children and may lead to ischemic heart disease or sudden death.Methods and Results. A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for >5 days and <4 classic criteria should undergo electrocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-␣ antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata.Conclusions. Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients. Pediatrics

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Section: Ivigmentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Pediatrics

1,697

2,533

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“…31 Coronary artery abnormalities were already present in all of the children, including giant aneurysms in two patients. Interestingly, all patients showed eventual normalization of their coronary arteries over the course of 2 years follow-up.…”

Section: Timing Of Therapymentioning

confidence: 93%

Role of intravenous immunoglobulin in the treatment of Kawasaki disease

Newburger

2017

Int J of Rheum Dis

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Intravenous immunoglobulin (IVIg) is a purified plasma product that is used for many immune-deficient conditions and autoimmune conditions. Use of IVIg for treatment for Kawasaki disease (KD) is critical for control of inflammation. The American Heart Association (AHA) recommends a single infusion of 2 g/kg preferably given during the first 10 days of illness. In this review, we have discussed the possible mechanisms of action of IVIg in KD and its clinical usage in this condition.

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“…It has been demonstrated that a single dose of 2 g/kg intravenous immunoglobulin G infused over 10-12 hours is more effective than multiple doses, and together with aspirin (Kato et al, 1996) now comprise the standard therapy in the USA, UK, Europe, Australia and many parts of Asia (Brogan et al, 2002). Although treatment should be instituted within the first ten days of illness, intravenous immunoglobulin G administration to children beyond the tenth day of illness is also recommended if they have either persistent fever without other explanation or aneurysms and ongoing systemic inflammation (Marasini et al, 1991; . The molecular basis for the anti-inflammatory action of intravenous immunoglobulin G is a field of extended research.…”

Section: Initial Treatmentmentioning

confidence: 99%

Kawasaki Disease in a Tertiary Pediatric Referral Center in Athens, Greece and Review of the Literature

Skevaki¹,

Charalampaki²,

Pinna³

et al. 2011

Advances in the Diagnosis and Treatment of Vasculitis

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Late intravenous gamma globulin treatment in infants and children with Kawasaki disease and coronary artery abnormalities

Cited by 61 publications

References 10 publications

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Role of intravenous immunoglobulin in the treatment of Kawasaki disease

Kawasaki Disease in a Tertiary Pediatric Referral Center in Athens, Greece and Review of the Literature

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