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Kawasaki Disease pp 175–179Cite as

Methylprednisolone Pulse Therapy for Nonresponders to Immunoglobulin Therapy

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Abstract

Intravenous methylprednisolone pulse (IVMP) therapy is administered to children with severe illnesses, such as Kawasaki disease (KD), collagen disease, and kidney disease, because of its powerful, rapid, and probably nongenomic immunosuppressive action. In a randomized controlled trial, IVMP plus initial intravenous immunoglobulin (IVIG) therapy did not decrease the incidence of coronary artery lesions (CAL) in KD patients as compared with IVIG plus placebo. Predicted nonresponders to IVIG treated with initial IVIG plus IVMP had earlier defervescence and lower incidence of CAL than did those treated with IVIG alone. Some studies showed that IVMP was effective for fast defervescence and prevention of CAL in nonresponders to initial or additional IVIG. The adverse effects of IVMP for KD patients include sinus bradycardia, hypertension, hyperglycemia, and hypothermia, but these effects were usually transient and not serious. Present evidence indicates that IVMP should be given as initial therapy for predicted IVIG nonresponders and as rescue therapy for confirmed nonresponders to initial or additional IVIG.

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Authors and Affiliations

  1. Division of Cardiology, Tokyo Metropolitan Children’s Medical Center, 2-8-29, Musashidai, Fuchu, Tokyo, 183-8561, Japan

    Masaru Miura

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  1. Masaru Miura
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Correspondence to Masaru Miura .

Editor information

Editors and Affiliations

  1. Advanced and Integrated Cardiovascular Research Course in the Young and Adolescence, Toho University, Tokyo, Japan

    Ben Tsutomu Saji

  2. Boston Children’s Hospital, Harvard Medical School, Department of Cardiology, Boston, Massachusetts, USA

    Jane W. Newburger

  3. Department of Pediatrics, Rady Children’s Hospital, University of California San Diego School of Medicine, La Jolla, USA

    Jane C. Burns

  4. Heart Center , Seattle Childrens Hospital, Seattle, USA

    Masato Takahashi

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© 2017 Springer Japan

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Miura, M. (2017). Methylprednisolone Pulse Therapy for Nonresponders to Immunoglobulin Therapy. In: Saji, B., Newburger, J., Burns, J., Takahashi, M. (eds) Kawasaki Disease. Springer, Tokyo. https://doi.org/10.1007/978-4-431-56039-5_18

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  • DOI: https://doi.org/10.1007/978-4-431-56039-5_18

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  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-56037-1

  • Online ISBN: 978-4-431-56039-5

  • eBook Packages: MedicineMedicine (R0)

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