PMID- 30307902
OWN - NLM
STAT- MEDLINE
DCOM- 20190107
LR  - 20190107
IS  - 1643-3750 (Electronic)
IS  - 1234-1010 (Print)
IS  - 1234-1010 (Linking)
VI  - 24
DP  - 2018 Oct 11
TI  - Intravenous Immunoglobulin Gamma (IVIG) versus IVIG Plus Infliximab in Young 
      Children with Kawasaki Disease.
PG  - 7264-7270
LID - 10.12659/MSM.908678 [doi]
AB  - BACKGROUND Kawasaki disease (KD) is a serious disease characterized by systemic 
      lesions of the skin and mucous membranes, as well as lymphomas and vascular 
      inflammation. KD threatens the health and lives of children, especially young 
      ones. Here, we compared the therapeutic effects of single intravenous 
      immunoglobulin gamma (IVIG) vs. a combination of IVIG and infliximab in young 
      children with Kawasaki disease (KD). MATERIAL AND METHODS A total of 154 children 
      with KD, younger than 5 years old, were enrolled in the study from January 2013 
      to January 2017. The patients were randomly divided into an IVIG group and a 
      combination of IVIG and infliximab treatment group. After systematic treatments, 
      the therapeutic indicators of the 2 groups were compared. During the treatment 
      process, body temperature and other important inflammatory indicators, including 
      C-reactive protein (CRP), white blood cell count (WBC), and tumor necrosis factor 
      alpha (TNF-alpha), were monitored in the first 4 days. RESULTS There were fewer 
      refractory KD patients in the combined treatment group than in the IVIG group (4 
      vs. 14, p<0.001). KD patients in the combined treatment group had better outcomes 
      with shorter fever durations and hospital stays, as well as less coronary artery 
      dilation. However, there was no obvious differences in the incidence rate of 
      coronary artery aneurysms between the 2 groups (p>0.05). Costs of administration 
      were similar between groups (p>0.05). Body temperature, CRP, WBC, and TNF-alpha in 
      the combined therapy group all showed an earlier drop than in the IVIG group, 
      indicating a more effective anti-inflammation effect. CONCLUSIONS The 
      introduction of IVIG combined with infliximab in the treatment of young children 
      with KD has more advantages than single IVIG therapy and can be considered as a 
      preferred treatment for KD. However, it would be necessary to further investigate 
      whether there is a significant difference in aneurysm frequency and long-term 
      outcome between these 2 strategies among a larger number of patients.
FAU - Han, Chun-Ling
AU  - Han CL
AD  - Maternity and Child Care Centre of Baoji, Baoji, Shaanxi, China (mainland).
FAU - Zhao, Suo-Lin
AU  - Zhao SL
AD  - Maternity and Child Care Centre of Baoji, Baoji, Shaanxi, China (mainland).
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20181011
PL  - United States
TA  - Med Sci Monit
JT  - Medical science monitor : international medical journal of experimental and 
      clinical research
JID - 9609063
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - B72HH48FLU (Infliximab)
SB  - IM
MH  - C-Reactive Protein/metabolism
MH  - Child, Preschool
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*administration & dosage/pharmacology
MH  - Infant
MH  - Infliximab/*administration & dosage
MH  - Leukocyte Count
MH  - Male
MH  - Mucocutaneous Lymph Node Syndrome/blood/*drug therapy
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor-alpha/blood
PMC - PMC6194751
COIS- Conflict of interest None.
EDAT- 2018/10/12 06:00
MHDA- 2019/01/08 06:00
PMCR- 2018/10/11
CRDT- 2018/10/12 06:00
PHST- 2018/10/12 06:00 [entrez]
PHST- 2018/10/12 06:00 [pubmed]
PHST- 2019/01/08 06:00 [medline]
PHST- 2018/10/11 00:00 [pmc-release]
AID - 908678 [pii]
AID - 10.12659/MSM.908678 [doi]
PST - epublish
SO  - Med Sci Monit. 2018 Oct 11;24:7264-7270. doi: 10.12659/MSM.908678.