PMID- 35911298
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220802
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 6
DP  - 2022 Jun
TI  - Intravenous Methylprednisolone Pulse Therapy Versus Intravenous Immunoglobulin in 
      the Prevention of Coronary Artery Disease in Children with Kawasaki Disease: A 
      Randomized Controlled Trial.
PG  - e26252
LID - 10.7759/cureus.26252 [doi]
LID - e26252
AB  - BACKGROUND: Kawasaki disease (KD) is often complicated by coronary artery lesion 
      (CAL), including dilatation or aneurysms. Intravenous immunoglobulin (IVIG) is 
      used with aspirin to prevent CAL in KD. OBJECTIVE: Given that the primary 
      treatment for other vasculitis is the use of corticosteroids, this study has been 
      performed to evaluate the effect of intravenous methylprednisolone pulse (IVMP) 
      therapy in preventing CAL in KD. METHOD: A randomized, single-blind clinical 
      trial was conducted on 40 KD patients aged six months to five years. Patients 
      were randomized into two groups according to the main treatment plan in addition 
      to aspirin: case group (IVMP for three consecutive days and then oral 
      prednisolone for three days) and control group (intravenous immunoglobulin 2 
      g/kg). Echocardiography was performed for all children at least three times, 
      during the acute phase, two weeks, and two months later. RESULTS: Data analysis 
      at the end of the study was done on 40 patients (20 patients in each group). 
      There were no significant differences in age and sex distribution, mean fever, 
      and acute phase duration, as well as baseline echocardiography in the two groups. 
      The frequency of CAL was 20% in the case group and 45% in the control group, 
      after two weeks (p<0.05), but there was no significant difference between two 
      groups in types of coronary artery lesion after two weeks and the frequency and 
      severity of CAL after two months. CONCLUSION: IVMP as initial line therapy 
      effectively control systemic and vascular inflammation and decrease coronary 
      artery damage in KD.
CI  - Copyright (c) 2022, Aslani et al.
FAU - Aslani, Nahid
AU  - Aslani N
AD  - Department of Pediatrics, Children's Medical Center, Pediatrics Center of 
      Excellence, Tehran, IRN.
AD  - Department of Pediatrics, Isfahan University of Medical Sciences, Tehran, IRN.
FAU - Raeeskarami, Seyed-Reza
AU  - Raeeskarami SR
AD  - Department of Pediatrics, Children's Medical Center, Pediatrics Center of 
      Excellence, Tehran, IRN.
AD  - Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IRN.
AD  - Department of Pediatrics, Pediatric Rheumatology Society of Iran, Tehran, IRN.
FAU - Aghaei-Moghadam, Ehsan
AU  - Aghaei-Moghadam E
AD  - Department of Pediatrics, Children's Medical Center, Pediatrics Center of 
      Excellence, Tehran, IRN.
AD  - Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IRN.
AD  - Department of Pediatrics, Pediatric Rheumatology Society of Iran, Tehran, IRN.
FAU - Tahghighi, Fatemeh
AU  - Tahghighi F
AD  - Department of Pediatrics, Children's Medical Center, Pediatrics Center of 
      Excellence, Tehran, IRN.
AD  - Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IRN.
AD  - Department of Pediatrics, Pediatric Rheumatology Society of Iran, Tehran, IRN.
FAU - Assari, Raheleh
AU  - Assari R
AD  - Department of Pediatrics, Children's Medical Center, Pediatrics Center of 
      Excellence, Tehran, IRN.
AD  - Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IRN.
AD  - Department of Pediatrics, Pediatric Rheumatology Society of Iran, Tehran, IRN.
FAU - Sadeghi, Payman
AU  - Sadeghi P
AD  - Department of Pediatrics, Children's Medical Center, Pediatrics Center of 
      Excellence, Tehran, IRN.
AD  - Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IRN.
AD  - Department of Pediatrics, Pediatric Rheumatology Society of Iran, Tehran, IRN.
FAU - Ziaee, Vahid
AU  - Ziaee V
AD  - Department of Pediatrics, Children's Medical Center, Pediatrics Center of 
      Excellence, Tehran, IRN.
AD  - Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IRN.
AD  - Department of Pediatrics, Pediatric Rheumatology Society of Iran, Tehran, IRN.
AD  - Department of Pediatrics, Pediatric Rheumatology Research Group, Rheumatology 
      Research Center, Tehran University of Medical Sciences, Tehran, IRN.
LA  - eng
PT  - Journal Article
DEP - 20220623
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9312282
OTO - NOTNLM
OT  - coronary artery lesion (cal)
OT  - intravenous immunoglobulin (ivig)
OT  - intravenous methylprednisolone pulse
OT  - kawasaki disease (kd)
OT  - pulse steroid therapy
OT  - systemic steroid therapy
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/08/02 06:00
MHDA- 2022/08/02 06:01
PMCR- 2022/06/23
CRDT- 2022/08/01 03:44
PHST- 2022/06/22 00:00 [accepted]
PHST- 2022/08/01 03:44 [entrez]
PHST- 2022/08/02 06:00 [pubmed]
PHST- 2022/08/02 06:01 [medline]
PHST- 2022/06/23 00:00 [pmc-release]
AID - 10.7759/cureus.26252 [doi]
PST - epublish
SO  - Cureus. 2022 Jun 23;14(6):e26252. doi: 10.7759/cureus.26252. eCollection 2022 
      Jun.