Sajiki Daichi, Nishio Nobuhiro, Kato Taichi, Hirao Takashi, Suzuki Kentaro, Go Kiyotaka, Kinoshita Fumie, Kidokoro Hiroyuki, Kawada Jun-Ichi, Sato Yoshiaki, Takahashi Yoshiyuki
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Advanced Medicine, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.
Sci Rep. 2025 May 27;15(1):18502. doi: 10.1038/s41598-025-03395-9.
Kawasaki disease (KD) is an acute vasculitis predominantly affecting younger children, and intravenous immunoglobulin (IVIG) treatment can reduce coronary artery lesion (CAL) development. This multicenter retrospective study aimed to evaluate whether using 10% immunoglobulin products, which allow for faster IVIG administration than conventional 5% immunoglobulin products, impact KD treatment outcomes. We analyzed data of 496 patients with KD from nine Japanese hospitals, divided into 5% (n = 247) and 10% (n = 249) immunoglobulin groups. The results show that the 10% immunoglobulin group had a shorter duration of IVIG infusion compared to the 5% group (12.9 vs. 24.3 h, P < 0.001) but had a lower cumulative incidence of fever resolution 24 h after starting IVIG (66.7% vs. 77.7%, P = 0.023), and the difference was maintained thereafter. The 10% group also had more IVIG nonresponders (24% vs. 17%, P = 0.046). There were no significant differences in the interval between primary and secondary treatment or in the incidence of CALs and severe adverse events. These findings suggest that while 10% immunoglobulin products facilitate faster IVIG administration, they may lead to increased nonresponse rates, highlighting the need for further studies to optimize KD treatment protocols, such as duration of IVIG administration.
川崎病（KD）是一种主要影响年幼儿童的急性血管炎，静脉注射免疫球蛋白（IVIG）治疗可减少冠状动脉病变（CAL）的发生。这项多中心回顾性研究旨在评估使用10%免疫球蛋白产品（与传统的5%免疫球蛋白产品相比，其能更快地输注IVIG）是否会影响KD的治疗结果。我们分析了来自日本9家医院的496例KD患者的数据，分为5%（n = 247）和10%（n = 249）免疫球蛋白组。结果显示，与5%组相比，10%免疫球蛋白组的IVIG输注时间更短（12.9小时对24.3小时，P < 0.001），但在开始IVIG治疗24小时后发热消退的累积发生率较低（66.7%对77.7%，P = 0.023），且此后差异一直存在。10%组的IVIG无反应者也更多（24%对17%，P = 0.046）。在初次和二次治疗的间隔时间、CALs的发生率以及严重不良事件方面，两组之间没有显著差异。这些发现表明，虽然10%免疫球蛋白产品有助于更快地输注IVIG，但它们可能会导致无反应率增加，这突出了需要进一步研究以优化KD治疗方案，如IVIG给药持续时间。
