Comparative effectiveness of intravenous

immunoglobulin from different manufacturing

processes on Kawasaki disease

Ming-Chih Lin

Taiwan, China

Author Affiliations: Division of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, China (Lin MC); Department of Pediatrics and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, China (Lin MC)

Corresponding Author: Ming-Chih Lin, MD, PhD, 1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan 40705, China (Tel: +886-4-23592525 ext. 8190; Fax: +886-4-23741359; Email: mingclin@gmail.com)

doi: 10.1007/s12519-014-0479-8

Background: The comparative effectiveness of intravenous immunoglobulin (IVIG) for Kawasaki disease was regarded as inconclusive in the international guidelines. However, several new evidences have been published in recent years.

Data sources: A literature search of PubMed was conducted using key words of "Kawasaki disease or mucocutaneous lymph node syndrome" and "immunoglobulin" in combination. Only original articles published after 2004 were selected. A total of 813 papers were found in PubMed. These papers were screened manually by their titles and abstracts.

Results: Patients treated with IVIG prepared by beta-propiolactonation might have worse outcome (a higher non-responsive rate in one report and a higher rate of coronary aneurysm in two reports). Storage of IVIG in acidic solution might be correlated with a higher rate of coronary aneurysm (two reports).

Conclusions: Different processes of preparation and conditions of preservation of IVIG may have profound effects on its clinical effectiveness. Randomized controlled studies are needed to further elucidate this issue.

Key words: coronary aneurysm; immunoglobulin; Kawasaki disease; treatment outcome

World J Pediatr 2014;10(2):114-118