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Adverse effects of methylprednisolone pulse therapy in refractory Kawasaki disease

¹ Department of Cardiology, Tokyo Metropolitan Kiyose Children’s Hospital, Tokyo, Japan
² Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan

Correspondence to:
Correspondence to:
Dr M Miura

Keywords: immunoglobulin therapy; Kawasaki disease; non-responders; randomised control study; steroid pulse

The first 150 words of the full text of this article appear below.

The efficacy and safety, including arrhythmia and sudden death,^1,2 of intravenous methylprednisolone pulse (IVMP) therapy in patients with Kawasaki disease (KD) are uncertain.

We conducted a control study in KD patients with persistent or recurrent fever (37.5°C) 48 hours after a single infusion of initial intravenous immunoglobulin (IVIG) 2 g/kg. At enrolment (day 1), the subjects were randomised to receive IVMP (30 mg/kg/day of methylprednisolone for three days), or additional IVIG (2 g/kg). Heparin was also continuously infused (15–20 units/kg/h) in the IVMP group. The study was halted prematurely because of adverse effects of IVMP when 22 patients were recruited; they accounted for 13% of KD patients treated with initial IVIG.

The antipyretic effect of IVMP was superior to that of additional IVIG on day 2 (p = 0.02, repeated measures analysis), but not on day 3 and later (fig 1). The fraction of febrile patients was significantly . . . [Full text of this article]

This article has been cited by other articles:

				T Furukawa, M Kishiro, K Akimoto, S Nagata, T Shimizu, and Y Yamashiro Effects of steroid pulse therapy on immunoglobulin-resistant Kawasaki disease Arch. Dis. Child., February 1, 2008; 93(2): 142 - 146. [Abstract] [Full Text] [PDF]

				J. D. Akikusa, B. M. Feldman, G. J. Gross, E. D. Silverman, and R. Schneider Sinus Bradycardia After Intravenous Pulse Methylprednisolone Pediatrics, March 1, 2007; 119(3): e778 - e782. [Abstract] [Full Text] [PDF]