[Kawasaki disease. Treatment with intravenous gammaglobulins]

Thirty French children (18 males, 12 females; mean age 20 +/- 18 months) presenting with Kawasaki disease were treated with high-dose intravenous plasmin-modified immunoglobulins (Veinoglobulines Institut Mérieux, France) during the acute phase of the disease. The total dose ranged from 1 to 2.5 g/kg (mean 1.88 +/- 0.50) administered in 1 to 5 infusions. In every case the clinical symptoms disappeared rapidly. Hyperfibrinaemia and hyperleucocytosis with granulocytosis regressed within one week, and high platelet counts within 2 to 3 weeks. the disappearance of immunological abnormalities paralleled that of clinical signs. Three-dimensional echocardiography showed dilatation of the left coronary artery in only one of the 30 children at 1 and 6 months, but coronary arteriography performed during the 6th month gave normal results. Intravenous immunoglobulin therapy seems to be effective in preventing the development of coronary aneurysms in patients with Kawasaki disease. The immunoregulatory function of immunoglobulins accounts for this effectiveness and for their value in immune diseases.