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The impact of single dose intravenous dexamethasone as an adjunctive therapy for primary treatment on concentrations of inflammatory biomarkers in children with Kawasaki disease

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Purpose: This study was performed to investigate the impact of single dose dexamethasone as an adjunctive therapy for primary treatment on values of inflammatory markers in children with Kawasaki disease (KD). Methods: We investigated inflammatory markers, including white blood cells, erythrocyte sedimentation rate, C-reactive protein (CRP), interleukin (IL)-6, and IL-10 in 42 children with complete KD who were hospitalized in the Kyungpook National University Children’s Hospital from March 2016 through April 2017. The children underwent primary treatment for KD with intravenous immunoglobulin (IVIG) and/or dexamethasone. They were divided into 2 groups according to the use of dexamethasone. To assess the change in values of inflammatory markers, the blood was drawn twice from each child; before and 24 hours after the administration of IVIG. Results: Of the 42 study children, 18 and 24 were classified as the dexamethasone and control groups, respectively. No significant differences were found between the 2 groups in terms of the length of hospital stay, duration of fever, and time required for IVIG administration. In both groups, white blood cells, CRP, IL-6, and IL-10 significantly decreased after the primary therapy. The delta scores of CRP, IL-6, and IL-10 were higher in the dexamethasone group (P = 0.015, P = 0.001, and P = 0.002, respectively). No coronary artery abnormalities were found in both groups. Conclusion: This study suggests an anti-inflammatory effect of single dose dexamethasone as an adjunctive therapy for primary treatment in children with KD without shortening the duration of fever and the length of hospital stay.

Abstract

Purpose: This study was performed to investigate the impact of single dose dexamethasone as an adjunctive therapy for primary treatment on values of inflammatory markers in children with Kawasaki disease (KD). Methods: We investigated inflammatory markers, including white blood cells, erythrocyte sedimentation rate, C-reactive protein (CRP), interleukin (IL)-6, and IL-10 in 42 children with complete KD who were hospitalized in the Kyungpook National University Children’s Hospital from March 2016 through April 2017. The children underwent primary treatment for KD with intravenous immunoglobulin (IVIG) and/or dexamethasone. They were divided into 2 groups according to the use of dexamethasone. To assess the change in values of inflammatory markers, the blood was drawn twice from each child; before and 24 hours after the administration of IVIG. Results: Of the 42 study children, 18 and 24 were classified as the dexamethasone and control groups, respectively. No significant differences were found between the 2 groups in terms of the length of hospital stay, duration of fever, and time required for IVIG administration. In both groups, white blood cells, CRP, IL-6, and IL-10 significantly decreased after the primary therapy. The delta scores of CRP, IL-6, and IL-10 were higher in the dexamethasone group (P = 0.015, P = 0.001, and P = 0.002, respectively). No coronary artery abnormalities were found in both groups. Conclusion: This study suggests an anti-inflammatory effect of single dose dexamethasone as an adjunctive therapy for primary treatment in children with KD without shortening the duration of fever and the length of hospital stay.

참고문헌 (18)

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