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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제55권 제5호
발행연도
2014.1
수록면
1,260 - 1,266 (7page)

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Purpose: To investigate the clinical effects of a single high dose intravenous immunoglobulin(IVIG) combined with initial dexamethasone as a primary treatment on Kawasaki disease (KD). Materials and Methods: Between January 2008 and December2010, we reviewed the medical records of 216 patients with complete KD patients that were admitted to a single medical center. 106 patients were treated with a single high dose of IVIG (2 g/kg) alone and 110 patients received IVIG and dexamethasone(0.3 mg/kg per day for three days). Results: The combined IVIG plus dexamethasone patient group had a significantly shorter febrile period and duration of hospital stay (1.4±0.7 days vs. 2.0±1.2 days, p<0.001; 5.8±1.7 days vs. 6.9±2.5 days, p<0.001, respectively) than the IVIG alone group. The combined IVIG plus dexamethasone group required IVIG retreatment significantly less than the IVIG only group (12.7% vs. 32%, p=0.003). After completion of the initial IVIG, C-reactiveprotein levels in the combined IVIG plus dexamethasone group were significantlylower than those in the IVIG only group (2.7±4.0 mg/dL vs. 4.6±8.7 mg/dL, p=0.03). In the combined IVIG plus dexamethasone group, the incidence of coronaryartery lesions tended to be lower without worse outcomes at admission after initialinfusion of IVIG and in follow-up at two months; however, the differences were not significant (8.2% vs. 11.3%, p=0.22; 0.9% vs. 2.8%, p=0.29). Conclusion: Initialcombined therapy with dexamethasone and a single high-dose of IVIG resulted in an improved clinical course, in particular a shorter febrile period, less IVIG retreatment,and shorter hospital stay without worse coronary outcomes.

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