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Preliminary Report

Mary Allen Engle, MD; Nunzia S. Fatica, MD; James B. Bussel, MD; John E. O'Loughlin, MD; Michael S. Snyder, MD; Martin L. Lesser, PhD

Am J Dis Child. 1989;143(11):1300-1304.

Abstract
• Gamma globulin administered in a single dose of 1 g/kg of body weight intravenously caused prompt clinical improvement in 27 of 32 consecutive children with Kawasaki disease treated by the 12th day of illness. Response was equally good for the 20 children treated in the first week and the 12 treated in the second week. Fever and clinical signs abated within the first day after treatment, the mean white blood cell count normalized by 48 hours, and the sedimentation rate continued to be elevated for about 2 weeks, while the platelet count rose during the first 2 weeks after treatment and returned to normal approximately 1 month after treatment. Five children with incomplete relief needed more than the single dose before resolution of signs and symptoms occurred. Coronary aneurysms in 2 patients before treatment regressed by 2 weeks. No patient developed coronary aneurysms. No child had sequelae of Kawasaki disease at a follow-up of 2 to 31 months. We believe that although this was a one-arm, uncontrolled pilot study, the results suggest that this protocol provides a safe, flexible, and effective treatment for acute Kawasaki disease.

(AJDC. 1989;143:1300-1304)

Author Affiliations
From the Divisions of Cardiology (Drs Engle, Fatica, O'Loughlin, and Snyder) and Hematology-Oncology (Dr Bussel), the Department of Pediatrics, and the Department of Public Health (Dr Lesser), The New York Hospital, Cornell University Medical College, New York; and the Division of Biostatistics, North Shore University Hospital, Manhasset, NY (Dr Lesser).

Footnotes
Accepted for publication May 10, 1989.

Read before the Northeast Pediatric Cardiology Society, Rye, NY, September 17, 1988, and the Third International Kawasaki Disease Symposium, Tokyo, Japan, December 1, 1988.

Reprint requests to The New York Hospital, Cornell Medical Center, 525 E 68th St, New York, NY 10021 (Dr Engle).

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