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Evidence summaries

Gammaglobulin Dose and Coronary Artery Abnormalities in Kawasaki Disease

Two grams/kg of intravenous gammaglobulin provides better protection against development of coronary abnormalities than smaller doses. Level of evidence: "A"

A systematic review 1 including 7 studies with a total of 1 629 subjects was abstracted in DARE. In 868 Japanese patients receiving moderate-dose aspirin (30 to 50 mg/kg per day), the prevalence of echocardiographic coronary artery abnormalities (CAA) at the subacute stage was 26.8% with aspirin alone, 18.1% with total intravenous gammaglobulin (IVGG) dose <1 gm/kg, 17.3% with total IVGG 1.0 to 1.2 gm/kg, and 5.3% with total IVGG dose of 2 gm/kg. In 761 U.S. patients receiving high-dose aspirin (80 to 120 mg/kg per day) the prevalence of CAA at the subacute stage was 23.0% with aspirin alone, 9.0% with a total IVGG dose of 1 gm/kg, 8.6% with total IVGG dose of 1.6 gm/kg, and 4.6% with total IVGG dose of 2 gm/kg.

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    References

    • Terai M, Shulman ST. Prevalence of coronary artery abnormalities in Kawasaki disease is highly dependent on gamma globulin dose but independent of salicylate dose. J Pediatr 1997 Dec;131(6):888-93. [PubMed] [DARE]

Primary/Secondary Keywords