Investigation of Kawasaki Disease Patients with Body Weights Above Twenty-five Kilograms

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  • 体重25kg以上の川崎病患児の検討

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Background: A single infusion of intravenous immunoglobulin (IVIG) in a dose of 2 g per kg of body weight is the recommended treatment for Kawasaki disease (KD). However, physicians sometimes hesitate to administer this dose of IVIG to patients with heavy body weight. This study aimed to investigate the characteristics, treatments, and outcomes of KD patients withe heavy body weight.<BR>Patients and Methods: Thirteen KD patients above 25 kg of body weight (25KD) were compared with 326 below 15 kg (15KD) regarding laboratory findings, treatments, and outcomes.<BR>Results: The mean age and body weight of the 25KD patients were 8 ± 2 years and 30 ± 6 kg, respectively. The 25KD patients had a significantly higher neutrophil proportion and C-reactive protein levels compared with 15KD patients. They also had significantly lower mean platelet counts and a higher mean Gunma score. IVIG treatment was initiated in twelve 25KD patients within their seventh illness day. The proportion of the recommended IVIG dose (g/day) administered to the 25KD patients averaged 92% for each IVIG regimen, which was significantly less than that of the 15KD patients (112%). The difference in the incidence of coronary artery abnormality between 25KD and 15KD patients was not statistically significant.<BR>Conclusions: The severity of the disease was worse in the 25KD patients compared with 15KD patients. However, following the initial treatment with IVIG, no 25KD patients required an additional IVIG treatment in this study. Further investigation to determine the adequate IVIG dose for KD patients withe heavy body weight is necessary.

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