The Effect of Early Immunoglobulin Treatment on the Course of Kawasaki Disease

Abstract

Objective: Controversies exist as to whether early treatment for Kawasaki disease might increase the need for additional intravenous immunoglobulin (IVIG) treatment and whether it could reduce cardiac complications. We conducted this study to add useful clues, which could be helpful when setting up a treatment plan. Methods: 359 patients who were newly diagnosed with Kawasaki disease at Severance Hospital were divided into two groups; patients who received IVIG treatment within 3 days (group A) and those who received IVIG treatment after 3 days (groups B and C). We compared the laboratory data, fever duration, frequency of additional IVIG treatment, and echocardiography follow-up results. Results: IVIG was administered 1.11±0.34 (mean±SD), 1.15±0.39, and 1.17±0.42 times in groups A, B, and C, respectively; p=0.29 (A vs. B), p=0.21 (A vs. C). The incidence of cardiac complications checked within the first 2 weeks from disease onset was 3.6%, 5.2%, and 5.1% in groups A, B, and C, respectively; p=0.52 (A vs. B), p=0.55 (A vs. C), and the values checked at 2 months were 3.6%, 5.6%, and 5.7% in groups A, B, and C, respectively; p=0.43 (A vs. B), p=0.43 (A vs. C). Conclusion: Early IVIG treatment in patients with Kawasaki disease decreased fever duration and may prevent cardiac complications by limiting inflammation.