OBJECTIVE: To determine whether different brands of intravenous immunoglobulin (IVIG) administered to children with Kawasaki disease (KD) result in different outcomes. STUDY DESIGN: We analyzed children with KD and divided them into 4 groups according to the brand of IVIG. A coronary artery abnormality (CAA) was defined as having a lumen diameter (inner border to inner border) of > or =3 mm in KD cases <5 years old and > or =4 mm in cases > or =5 years old, and giant aneurysm was defined as a lumen diameter > or =8 mm. Patients were considered nonresponsive to IVIG therapy if fever persisted longer than 2 days after completion of treatment and needed retreatment with IVIG. RESULTS: We collected 437 cases, 29 (6.6%) were nonresponsive, 17 (3.9%) had CAA at convalescence, and 3 (0.7%) had giant aneurysm, 2 of whom had development of myocardial infarcts. Patients receiving Brand C IVIG, prepared with beta-propiolactone, had higher rates (10%, 9/93, P = .01) of CAA at convalescence and nonresponsiveness (13%, 12/93, P = .001); giant aneurysm occurred in 3/93 (3%) receiving Brand C IVIG and in 0/344 who received the other 3 brands (P = .008). CONCLUSIONS: IVIG, prepared with beta-propiolactone, was most significantly associated with nonresponsiveness, CAA at convalescence, and giant aneurysm. Physicians should be cautious when using IVIG prepared with beta-propiolactone or enzyme digestion to treat KD.
OBJECTIVE: To determine whether different brands of intravenous immunoglobulin (IVIG) administered to children with Kawasaki disease (KD) result in different outcomes. STUDY DESIGN: We analyzed children with KD and divided them into 4 groups according to the brand of IVIG. A coronary artery abnormality (CAA) was defined as having a lumen diameter (inner border to inner border) of > or =3 mm in KD cases <5 years old and > or =4 mm in cases > or =5 years old, and giant aneurysm was defined as a lumen diameter > or =8 mm. Patients were considered nonresponsive to IVIG therapy if fever persisted longer than 2 days after completion of treatment and needed retreatment with IVIG. RESULTS: We collected 437 cases, 29 (6.6%) were nonresponsive, 17 (3.9%) had CAA at convalescence, and 3 (0.7%) had giant aneurysm, 2 of whom had development of myocardial infarcts. Patients receiving Brand C IVIG, prepared with beta-propiolactone, had higher rates (10%, 9/93, P = .01) of CAA at convalescence and nonresponsiveness (13%, 12/93, P = .001); giant aneurysm occurred in 3/93 (3%) receiving Brand C IVIG and in 0/344 who received the other 3 brands (P = .008). CONCLUSIONS: IVIG, prepared with beta-propiolactone, was most significantly associated with nonresponsiveness, CAA at convalescence, and giant aneurysm. Physicians should be cautious when using IVIG prepared with beta-propiolactone or enzyme digestion to treat KD.
Authors: Chiea Chuen Khor; Sonia Davila; Willemijn B Breunis; Yi-Ching Lee; Chisato Shimizu; Victoria J Wright; Rae S M Yeung; Dennis E K Tan; Kar Seng Sim; Jie Jin Wang; Tien Yin Wong; Junxiong Pang; Paul Mitchell; Rolando Cimaz; Nagib Dahdah; Yiu-Fai Cheung; Guo-Ying Huang; Wanling Yang; In-Sook Park; Jong-Keuk Lee; Jer-Yuarn Wu; Michael Levin; Jane C Burns; David Burgner; Taco W Kuijpers; Martin L Hibberd Journal: Nat Genet Date: 2011-11-13 Impact factor: 38.330
Authors: Yue Wang; Zhen Li; Guang Hu; Shiying Hao; Xiaohong Deng; Min Huang; Miao Ren; Xiyuan Jiang; John T Kanegaye; Kee-Soo Ha; JungHwa Lee; Xiaofeng Li; Xuejun Jiang; Yunxian Yu; Adriana H Tremoulet; Jane C Burns; John C Whitin; Andrew Y Shin; Karl G Sylvester; Doff B McElhinney; Harvey J Cohen; Xuefeng B Ling Journal: PLoS One Date: 2016-12-21 Impact factor: 3.240