The efficacy for reduction of
coronary aneurysm in
Kawasaki disease was studied from 1984 to 1988 in Taiwan. One hundred and six children with
Kawasaki disease were treated by one of the following regimens: regimen I:
aspirin and 130-200 mg/kg/day of intravenous
gamma-globulin (group I = 7), regimen II: 201-400 mg/kg/day of intravenous
gamma-globulin with
aspirin (group II = 49) and regimen III:
aspirin alone (group III = 43) and no treatment (group IV = 7). By using two-dimensional echocardiography and aortography, the coronary arterial
aneurysms noted in group I, II, III and IV were 42.9%, 49.0%, 44.2% and 16.7% respectively within 4 weeks of the illness and were 28.6%, 18.4%, 16.4% and 16.7% respectively during the follow-up period of 11.4 +/- 8.2 months. The incidence of
coronary aneurysm was reduced significantly (p less than 0.005) in patients with high-dose
gamma-globulin therapy and with
aspirin therapy alone. However, there was no difference between group II and III, probably due to delays in the time of start of prophylactic
gamma-globulin therapy. There was also significant lower incidence of the giant
coronary aneurysm in children with high dose
gamma-globulin therapy and with
aspirin therapy. (p less than 0.05) The incidences of giant
aneurysm in groups I, II, III and IV were 28.6%, 2.0%, 4.7% and 14.3% respectively. These results suggest that even with delay in the time of start of prophylactic
gamma-globulin therapy, it still can reduce the formation of giant
coronary aneurysm.