Key result
Aspirin plus high-dose gamma-globulin linked to ~39% improvement in Kawasaki disease carditis severity.
Why the study?
The utility of Tc-99m HMPAO WBC imaging to detect carditis and evaluate treatment effects in Kawasaki disease was investigated.
Does Tc-99m HMPAO WBC imaging detect changes in carditis severity following aspirin and high-dose gamma-globulin treatment in children with Kawasaki disease?
Observational (n=18)
Does Tc-99m HMPAO WBC imaging detect changes in carditis severity following aspirin and high-dose gamma-globulin treatment in children with Kawasaki disease?
p-value: p=<0.001
Tc-99m HMPAO WBC imaging may be a useful modality for detecting carditis and evaluating the therapeutic response to aspirin and high-dose gamma-globulin in patients with Kawasaki disease.
Serial Tc-99m HMPAO WBC imaging may track carditis response to IVIG in Kawasaki disease; leaves open clinical utility pending larger studies.
Eighteen patients with Kawasaki disease and suspected carditis (11 boys, 7 girls, mean age 18 months) in acute stages underwent Tc-99m HMPAO WBC imaging of the heart. Signs and symptoms subsided after conventional aspirin therapy and the intravenous injection of high-dose (400 mg/kg per day for 5 days) gamma-globulin treatments. Tc-99m HMPAO WBC imaging of the heart was arranged a second time to evaluate the effects of the treatments for carditis. The results showed that a significant difference existed in the severity of carditis before and after the treatments (P less than 0.001, by signed rank test), 39% (7/18) with significant improvement in severity of carditis, 50% (9/18) without definite change. However, 11% (2/18) became more severely ill after the treatments. Tc-99m HMPAO WBC imaging may be useful in detecting carditis in Kawasaki disease and in evaluating the effects of aspirin plus the newly recommended gamma-globulin for the treatment of carditis in Kawasaki disease.
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Kao et al. (1992) conducted an observational in Kawasaki disease and suspected carditis (n=18). Aspirin and high-dose gamma-globulin vs. Baseline (before treatment) was evaluated on Severity of carditis before and after treatments (p=<0.001). Aspirin and high-dose gamma-globulin treatment significantly altered carditis severity in Kawasaki disease, with 39% showing improvement on Tc-99m HMPAO WBC imaging (P<0.001).
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