Factors related to cardiac sequelae of Kawasaki disease

Among the 35,210 patients with Kawasaki disease who were reported in nation wide surveys from 1991 to 1996, 83% were treated with gamma-globulin (GG). Those treated with a total dose of 1000 mg;kg (9098 patients) and 2000 mg/k g (7012 patients) were selected as the subjects of the study on the relatio nship between the development of cardiac sequelae, in particular of giant a neurysms, and related factors using logistic regression models. Among the t wo groups that received 1000 mg/kg and 2000 mg/kg, respectively, the odds r atios for cardiac sequelae were significantly high for males, these <6 mont hs and greater than or equal to 7 years of age, and typical or recurrent ca ses. Except for those <6 months of age, the odds ratios of all the factors mentioned above were higher for the incidence of giant coronary aneurysms t han those for cardiac sequelae. The preventive effects of GG therapy for ca rdiac sequelae and in particular giant aneurysms, were significantly low wh en GG administration was initiated on day 8 or later after onset. In the gr oup treated with 1000 mg/kg, the preventive effect was low when GG administ ration was spread over 3 days or longer. Conclusion To prevent the development of cardiac sequelae, in particular gi ant coronary aneurysms, gamma-globulin therapy should be started as soon as possible and be completed within 2 days.