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Abstract Ref Number = APCP772
Poster Presentation
The Efficacy of Intravenous Immunoglobulin and Oral Corticosteroid Therapy in Children with Kawasaki Disease
Sonya Leonardy Low,Bella Kurnia
Hermina Kemayoran Hospital Hermina Podomoro Hospital
Background : Immunoglobulin and oral corticosteroid therapy showed a clinical improvement by reducing the development abnormalities coronary artery in Kawasaki Disease
Case Presentation Summary : A 4 years old boy previously had fever lasting for 7 days with unilateral cervical lymphadenopathy, bilateral conjunctival injection, reddish tongue normally called “ strawberry tongue”, polymorphous rash, discomfort on his chest and presence of coronary artery abnormalities on the result of echocardiography with right artery coronary 1,98 mm dilatation. A laboratory examination showed an increasing CRP, thrombocyte, and LED which was concluded to inflammation and support the clinical examination that leads to “Classical Type” of Kawasaki Disease. Immunoglobulin therapy and oral corticosteroid were given immediately for 10 days and it showed clinical improvement on this patient
Learning Points/Discussion : Immunoglobulin and oral corticosteroid therapy in Kawasaki Disease depress the inflammation of the vascular due to vasculitis in Kawasaki Disease. Echocardiography should be done to Kawasaki patient to see the progression development of vascular abnormalities. The efficacy of IVIG administered in the acute phase of Kawasaki disease was known to reduce the prevalence of coronary artery abnormalities. IVIG should be given as early as possible within the first 10 days of illness onset of fever. From many studies on IVIG dose regimens, higher dose of IVIG given in a single infusion have the greatest efficacy. Oral corticosteroid was also evaluated for the treatment of acute and refractory Kawasaki disease. A meta-analysis found that using corticosteroids in addition to IVIG as initial treatment significantly reduced the risk of coronary abnormalities compared with IVIG alone.
Keywords: corticosteroid Kawasaki disease Immunoglobulin IVIG
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