Impact of Early Treatment with High-Dose Intravenous Immunoglobulin on Incidence of Kawasaki Disease Complications in Iranian Children

Alireza  Karimi Yazdi; Parvin Akbariasbagh; Yahya Aghighi; Seyyed Reza  Raeeskarami; Khadije Toomaj; Sahar Heidari; Shahnaz Alamdari; Leyla Sahebi

doi:10.18502/jfrh.v15i4.7890

Alireza Karimi Yazdi Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Parvin Akbariasbagh Department of Pediatrics, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Yahya Aghighi Department of Pediatrics, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Seyyed Reza Raeeskarami Department of Pediatrics, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Khadije Toomaj Department of Pediatrics, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Sahar Heidari Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Shahnaz Alamdari Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Leyla Sahebi Family Health Research Institute, Maternal-Fetal, and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jfrh.v15i4.7890

Keywords: Mucocutaneous Lymph Node Syndrome; Aspirin; Immunoglobulins; Coronary Artery Disease; Hearing disorders

Abstract

Objective: Kawasaki disease (KD) occurs in five-year-old or younger children. This study aimed to evaluate the impact of high-dose intravenous immunoglobulin plus acetylsalicylic acid therapy on the prevention and treatment of coronary artery lesions and to evaluate the impact of high-dose acetylsalicylic acid (ASA) on the hearing of the patients.

Materials and methods: In this retrospective cohort study, 31 patients with KD were followed from January 2012 to December 2015. The clinical, para-clinical, color Doppler echocardiogram and audiometry results were evaluated.

Results: Overall, seven cases (22.6%) developed coronary artery aneurysm (CAA) in the acute phase of the disease, of whom only two still had CAA at the end of the treatment (6%). One of the five children with CAA recovery had a delay in the onset of treatment and one of two patients with persistent CAA at the end of treatment was admitted within the first 10 days. There was no evidence-based abnormal liver biochemical test. None of the patients developed sensorineural hearing loss (SNHL) on audiometry tests conducted before and after treatment.

Conclusion: Recovery of coronary artery lesions was 71.43% after 28 days of the onset of treatment. The distribution of coronary artery aneurysm was not different in terms of the time of the treatment initiation (P-Value = 0.371). None of the children had a sensorineural hearing loss (SNHL) 48 hours and 4 weeks after treatment.