Intravenous Immune Globulin for Kawasaki Disease
Molly Miloslavsky
Eli Miloslavsky
The Treatment of Kawasaki Syndrome With Intravenous Gamma Globulin
Newburger JW, Takahashi M, Burns JC, et al. N Engl J Med. 1986;315(6):341–347
Background
Kawasaki disease (KD) is a medium-vessel vasculitis that primarily affects children under the age of 5, and is one of the leading causes of acquired pediatric heart disease. Due to its anti-inflammatory effects, aspirin had been the mainstay of therapy although it had not been shown to prevent the development of coronary artery aneurysms. An unblinded study from Japan demonstrated that IV immune globulin (IVIG) may prevent development of coronary artery lesions in children with KD but no randomized trials had been conducted.1
Objectives
To compare aspirin alone vs. aspirin plus IVIG in preventing coronary artery aneurysms in children with KD.
Methods
Randomized controlled trial in 6 US hospitals from 1984 to 1985.
Patients
168 children (mean age 2.5 years) who met at least 5/6 inclusion criteria: fever, nonexudative conjunctivitis, oropharyngeal changes (strawberry tongue, dry fissured lips, and mucosal erythema), changes in extremities (erythema of palms/soles, edema of hands/feet), rash, and cervical lymphadenopathy. Select exclusion criteria: symptoms >10 days.
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