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Clinical outcome of patients with refractory Kawasaki disease based on treatment modalities

Hyun Jung Kim1, Hyo Eun Lee1, Jae Won Yu2

  • 1Department of Pediatrics, Eulji Universitiy School of Medicine, Daejeon, Korea.

Korean Journal of Pediatrics
|September 10, 2016
PubMed

Insights

Adjuvant therapies for refractory Kawasaki disease (KD) showed varied effectiveness in preventing coronary artery lesions (CAL). Further randomized trials are needed to confirm findings in KD patients.

Area of Science:

  • Pediatrics
  • Cardiology
  • Immunology

Background:

  • Kawasaki disease (KD) is a critical pediatric illness.
  • Refractory KD cases pose challenges in treatment.
  • Coronary artery lesions (CAL) are a major complication of KD.

Purpose of the Study:

  • To characterize refractory KD patients.
  • To evaluate the impact of adjuvant therapies on CAL development.
  • To assess outcomes in patients receiving multiple treatments.

Main Methods:

  • Retrospective analysis of 38 refractory KD patients (Jan 2012-Mar 2015).
  • Group 1: >3 IVIG + steroid therapy (n=7).
  • Group 2: Initial IVIG unresponsiveness requiring steroids or second IVIG (n=31).

Main Results:

  • Group 1 had a longer fever duration (13.0±4.04 days) than Group 2 (8.87±2.30 days).
  • All Group 1 patients achieved CAL suppression.
  • Coronary artery aneurysms occurred in 6.4% of Group 2 patients; all patients receiving only steroids developed CALs.

Conclusions:

  • No significant difference in CAL development between groups.
  • Further prospective, randomized studies are essential.
  • The efficacy of adjunctive therapies in refractory KD requires more investigation.
Abstract

Keywords:
Adjuvant therapyCoronary diseaseMucocutaneous lymph node syndrome

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