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Bradycardia Associated with Prednisolone in Children with Severe Kawasaki Disease

Akito Nagakura1, Yoshihiko Morikawa2, Hiroshi Sakakibara1

  • 1Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

The Journal of Pediatrics
|March 28, 2017
PubMed

Insights

Bradycardia is common in Kawasaki disease patients treated with prednisolone and intravenous immunoglobulin (IVIG). This bradycardia is linked to how well patients respond to the IVIG treatment.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Immunology

Background:

  • Kawasaki disease is a critical pediatric illness requiring prompt treatment.
  • Intravenous immunoglobulin (IVIG) is a standard therapy, often combined with corticosteroids like prednisolone.
  • The cardiac effects of combined IVIG and prednisolone therapy require further investigation.

Purpose of the Study:

  • To determine the prevalence of bradycardia in Kawasaki disease patients receiving prednisolone.
  • To analyze the association between bradycardia and treatment responsiveness to IVIG.

Main Methods:

  • A retrospective cohort study of 176 severe Kawasaki disease patients.
  • Comparison between patients receiving IVIG plus prednisolone and IVIG monotherapy.
  • Bradycardia defined as heart rate below the first percentile for age.

Main Results:

  • Bradycardia occurred in 79.1% of patients on IVIG plus prednisolone, versus 7.1% on IVIG alone (P < .001).
  • Prednisolone reduced heart rate by an average of 15.1 beats/minute from day 2-7.
  • Bradycardia was significantly associated with responsiveness to initial therapy (OR 7.2; P < .001).

Conclusions:

  • Bradycardia is a frequent occurrence in Kawasaki disease patients treated with IVIG and prednisolone.
  • The observed bradycardia is associated with treatment responsiveness, suggesting a potential biomarker.
Abstract

Keywords:
Kawasaki diseasechildrencorticosteroidsheart rateside effect

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