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KMID : 0857220070110020124
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Journal of the Korean Pediatric Cardiology Society
2007 Volume.11 No. 2 p.124 ~ p.130
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Coronary Complocation according to Retrearment of Immune Globulin in Kawasaki Disease
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Kim Sang-Eun
Park So-Hyun
Koh Dae-Kyun
Oh Jin-Hee
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Abstract
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Purpose: Recently most of patients with Kawasaki disease (KD) get treatment within several days of illness. But, some patients still suffer from coronary complication (CC) despite early initial treatment with intravenous immune globulin (IVIG) and even the additional therapy. We investigated the risk factors of CC in non-responders to initial therapy who needed additional IVIG infusion among patients with KD.
Methods: Forty five non-responders to initial IVIG who got additional IVIG infusion were reviewed from 1996 to 2007. We devided patients into two groups with CC (group A, n=17) or without CC (group B, n=28). Clinical characteristics, timing of additional IVIG infusion and laboratory results were reviewed. And we investigated the differences between the two groups and tried to find risk factors of CC.
Results : In comparison between the two groups, CC, clinical characteristics and timing of IVIG infusion were not different between two groups. But, total febrile days were significantly longer and peak platelets counts were significantly higher in group A (P=0.006, P=0.013). On the logistic regression analysis, total febrile days longer than 10.5 days was the only risk factor of CC in these patients.
Conclusion : Our results showed that patients with CC inspite of repeated IVIG therapy had longer fever duration. So, additional therapy besides re-treatment with IVIG aiming at shortening total duration of fever seems to be important in refractory KD to prevent CC.
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KEYWORD
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Kawasaki disease, Coronary aneurysm, Non-responders, Re-treatment, Intravenous im-mune globulin
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