Hamedi, Abdolkarim, ghahremani, Sarah, Malek, Abdolreza, Ghahremani, Somayeh, Ataei Nakhaei, Alireza. (1396). Use of Corticosteroid in Children with Unresponsiveness to Intravenous Immunoglobulin in Kawasaki Disease. , 5(8), 5555-5560. doi: 10.22038/ijp.2016.7117
Abdolkarim Hamedi; Sarah ghahremani; Abdolreza Malek; Somayeh Ghahremani; Alireza Ataei Nakhaei. "Use of Corticosteroid in Children with Unresponsiveness to Intravenous Immunoglobulin in Kawasaki Disease". , 5, 8, 1396, 5555-5560. doi: 10.22038/ijp.2016.7117
Hamedi, Abdolkarim, ghahremani, Sarah, Malek, Abdolreza, Ghahremani, Somayeh, Ataei Nakhaei, Alireza. (1396). 'Use of Corticosteroid in Children with Unresponsiveness to Intravenous Immunoglobulin in Kawasaki Disease', , 5(8), pp. 5555-5560. doi: 10.22038/ijp.2016.7117
Hamedi, Abdolkarim, ghahremani, Sarah, Malek, Abdolreza, Ghahremani, Somayeh, Ataei Nakhaei, Alireza. Use of Corticosteroid in Children with Unresponsiveness to Intravenous Immunoglobulin in Kawasaki Disease. , 1396; 5(8): 5555-5560. doi: 10.22038/ijp.2016.7117

Use of Corticosteroid in Children with Unresponsiveness to Intravenous Immunoglobulin in Kawasaki Disease

Journal of Pediatric Perspectives
مقاله 16، دوره 5، شماره 8 - شماره پیاپی 44، 2017، صفحه 5555-5560    اصل مقاله (313.88 K)
شناسه دیجیتال (DOI): 10.22038/ijp.2016.7117
نویسندگان
Abdolkarim Hamedi1؛ Sarah ghahremani* 2؛ Abdolreza Malek3؛ Somayeh Ghahremani4؛ Alireza Ataei Nakhaei2
1Infection Control and Hand Hygiene Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
2Specialist of pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3Pediatric Rheumatologist, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4Assistant of Nuclear Medicine, Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده
Background
Kawasaki Disease (KD) is a vasculitis with multi-organ involvementof unknown etiology; it is the most common cause of pediatric-heart diseases in developed countries. Treatment with Intravenous Immunoglobulin (IVIG) prevents coronary artery lesions; although there are some IVIG-resistant cases, combination therapy with corticosteroids and IVIG is one of the recommendations for treatment of these cases. The aim of this study was to compare these three options for treatment of Kawasaki Disease and to evaluate their ability to deal with coronary artery complication of Kawasaki Disease.
Materials and Methods
A prospective cross- sectional study of hospitalized cases of Kawasaki Disease, conducted in pediatric department of Imam Reza hospital, Mashhad-Iran, during 2013 to 2015 (18 months). Based on demographic and clinical data of these patients, children with high risk of unresponsiveness to IVIG therapy (based on Harada score), were determined and treated with IVIG and corticosteroids- combination initially. Follow-up patients for heart complications were 6 weeks.
Results
Twenty five patients (89.2%) out of total 28 hospitalized patients in this period of time who fulfilled diagnostic criteria were considered as complete Kawasaki Disease. Coronary Artery Lesions (CALs) were shown in 4 patients during the follow-up period, with high risk in patients with incomplete presentation (33.3% versus 12%, p <0.05). None of the children were treated with IVIG and corticosteroids combination therapy at the onset showed coronary artery lesions.
Conclusion
The current study showed that IVIG plus intravenous methylprednisolone (IVMP) combination therapy is a safe and effective treatment regimen in prevention of CALs.
کلیدواژه‌ها
Children؛ Coronary artery lesions؛ Corticosteroid؛ Kawasaki
آمار
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