Intravenous immunoglobulin therapy for older children with Kawasaki disease

The risk-benefit balance of the full dose intravenous immunoglobulin (IVIG) infusion of 2 g/kg body weight/dose in older children has not been established. In this study, I investigated the safety and efficacy of this therapy for older children. In total, I recruited 210 children who had received 2 g/kg/dose of IVIG therapy for Kawasaki disease between 1999 and 2015 at the Department of Pediatrics, Aomori Prefectural Central Hospital. The children were divided into two groups: an older group, comprising 18 children who were ≧ 72 months-old, and a younger group, comprising 192 children who were ≦ 71 months-old. The 18 children of the older group received a median IVIG dose of 50 g/dose (range, 36−105). None of the children had any major complications, including thrombosis. The prevalence of coronary artery lesions (CAL) before 30 days of illness was similar between the older and younger groups (1 / 18 vs. 9 / 192, P = 1.000). No older children had CAL after 30 days. An IVIG infusion of 2 g/kg/dose for older children with Kawasaki disease may be safe and effective for suppressing CAL caused by Kawasaki disease.