Lebranchu Y
Laboratoire d'Immunologie, Faculté de Médecine, Tours.
Presse Med. 1989 Jun 10;18(23):1147-50.
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.
30名患有川崎病的法国儿童（18名男性，12名女性；平均年龄20±18个月）在疾病急性期接受了大剂量静脉注射纤溶酶修饰的免疫球蛋白（法国梅里埃研究所的静脉用免疫球蛋白）治疗。总剂量为1至2.5 g/kg（平均1.88±0.50），分1至5次输注。在每种情况下，临床症状均迅速消失。高纤维蛋白血症、伴有粒细胞增多的白细胞增多症在1周内消退，高血小板计数在2至3周内消退。免疫异常的消失与临床症状的消失同步。三维超声心动图显示，30名儿童中只有1名在1个月和6个月时出现左冠状动脉扩张，但在第6个月进行的冠状动脉造影结果正常。静脉注射免疫球蛋白治疗似乎对预防川崎病患者冠状动脉瘤的发生有效。免疫球蛋白的免疫调节功能解释了这种有效性及其在免疫疾病中的价值。
