Ulinastatin Treatment for Kawasaki Disease

Abstract

Purpose Is ulinastatin administration an effective treatment for Kawasaki disease? We investigated the ulinastatin administration and other factors that might influence the duration of fever and C-reactive protein (CRP) in the children sufferin g from Kawasaki disease. Method We planed multi-center and retrospective study. We investigated 80 patients in the 12 institutions from March 1998 to May 2001. Three patients were excluded because of a readministration of high-dose gamma glob u lin. 44 female and 33 men were treated by high-dose gamma globulin: a single administration of 2g/kg or ulinastatin administration with high-dose gamma globulin. Ulinastatin was infused 5000/kg x 3 per day intravenously when the patients has high tempe r at ure. Their age was 2.8 +/- 2.4 years old. 43 patients were treated by high-dose gamma globulin and 31 patients were treated by high-dose gamma globulin with ulinastatin. We analyzed a correlation between the duration of fever and CRP, and following f ac tor s; age, sex, maximum CRP, maximal white blood cell count, minimal albumin concentration, minimal hemoglobin concentration and treatment protocols, by multiple regression analysis. Result The duration of fever and CRP from the start of t rea tmen ts were 41 +/- 39 hours and 8.8 +/- 5.4 days. Maximal CRP value was 10.0 +/- 7.2 mg/dl. The duration of fever significantly correlated with age and minimal albumin concentration (regression coefficient were 4.57 and -19.1; p<0.02 and p<0.03, re spect ively). The duration of CRP was significantly correlated with age (regression coefficient was 1.05; p<0.0003). Neither the duration of fever nor CRP was correlated with treatment protocols with or without ulinastatin. Conclusion The a dditio nal ulinastatin treatment with high-dose gamma globulin do not influence the duration of fever and CRP in our cases.