The Selection of the Group with Sufficient and Insufficient Effect to Gamma Globulin Therapy in the Kawasaki Disease

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(Objective) The effectiveness of high dose intravenous gamma globulin (IVGG) therapy in the Kawasaki disease (KD) has already been established. This time, we originally produced the treatment protocol. Using this protocol, the groups with sufficient and insufficient effect to IVGG therapy were determined. In addition, frequency and characteristics of both group were analyzed. (Patients and methods) Forty five patients of starting the IVGG therapy within the seventh illness day were made to be an object. The IVGG therapy was done by following methods. The effect was judged after treatment start 48 hours. The IVGG therapy (1g/kg) was made to be an end, if there were antipyresis and improvement tendency of CRP. The effect insufficient cases added 1g/kg IVGG. As examination items, frequency of coronary artery lesions (CAL) and laboratory findings (CRP, WBC, PMN, Ht, Pl, Alb, ChE, IgG) were chosen. (Results) (1) The one time administrated group (A group) was 31 cases (69%), and the additional dosage group (B group) was 14 cases (31%). (2) The patients with CAL were 1/31 in the A group and 5/14 in the B group. (3) There was no significance at CRP, WBC, Ht, Pl, Alb in both groups. In the B group, PMN counts were significantly high, and ChE, IgG were significantly low. (Conclusions) (1) In about 70% of the cases, the sufficient effect was obtained in the single dose of 1g/kg IVGG therapy. (2) In the group with the sufficient effect, CAL could not be seldom recognized. (3) As a method of the selection of both groups, it seemed to be the most appropriate to judge the the therapy effect by the administration of 1g/kg IVGG. (4) It is possible that this therapy reduces the quantity of using IVGG, and there is an economical advantage.