Pediatric Infection and Vaccine
- Volume 15 Issue 2
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- Pages.180-187
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- 2008
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- 2384-1079(pISSN)
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- 2384-1087(eISSN)
Characteristics of Kawasaki Disease Patients who are Unresponsive to High-dose Intravenous Immunoglobulin Therapy
가와사끼병에서 정맥용 면역글로불린 불응군의 특성
- Kook, Dong-Hyuk (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
- Ko, Yong-Min (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
- Lee, Keun-Young (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
- Kim, Dong-Un (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
- Lee, Kyung-Yil (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
- Lee, Joon-Sung (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
- 국동혁 (가톨릭대학교 의과대학 소아과학교실) ;
- 고용민 (가톨릭대학교 의과대학 소아과학교실) ;
- 이근영 (가톨릭대학교 의과대학 소아과학교실) ;
- 김동언 (가톨릭대학교 의과대학 소아과학교실) ;
- 이경일 (가톨릭대학교 의과대학 소아과학교실) ;
- 이준성 (가톨릭대학교 의과대학 소아과학교실)
- Published : 2008.12.25
Abstract
Purpose : We wanted to determine the characteristics of patients with Kawasaki disease (KD) who were unresponsive to intravenous immunoglobulin (IVIG). Methods : The patients with KD were divided into two groups: the IVIG responsive group (25 cases) and the IVIG unresponsive group (14 cases). We analyzed various parameters before and after the administration of IVIG, including the complete blood cell count with the differential count (%), the erythrocyte segmentation rate (ESR), the C-reactive protein (CRP) level and the protein and lipid profiles. Results : The IVIG unresponsive group had a prolonged duration of fever and a higher incidence of CAL compared to the IVIG responsive group (P<0.001, respectively). Before IVIG infusion, the neutrophil differential, the ESR and the CRP values were higher (P<0.001), and the total protein and albumin values were lower in the IVIG unresponsive group (P=0.01) compared to the IVIG responsive group. After IVIG infusion, there were no significant changes in the WBC count and CRP levels in the IVIG unresponsive group. The reduction of the HDL-cholesterol levels by IVIG was more significant in the unresponsive group (P=0.02). Conclusion : A more severe and prolonged inflammatory response occurred in the IVIG unresponsive group at an early stage, and this finding can be detected by such inflammatory parameters as the neutrophil count and the CRP and HDL-cholesterol levels after IVIG infusion.
목 적 : 가와사끼병에서 염증의 심한 정도는 장기간의 발열 기간, 초기 정맥용 면역글로불린 치료의 불응성에 의해 반영되며, 관상 동맥 병변의 고위험도와 관계가 있다. 본 연구자들은 IVIG 불응군의 특성을 알아보기 위해, IVIG 반응군과 비교하는 연구를 시행하였다. 방 법 : 2004년 3월부터 2008년 2월 동안, 가톨릭대학교 의정부 성모병원에 입원한 가와사끼병 환아들을 두 군으로 나누었다. IVIG 반응군(25명)은 IVIG 초기 치료 이후 24시간 이내
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