The treatment of Kawasaki syndrome with intravenous gamma globulin

N Engl J Med. 1986 Aug 7;315(6):341-7. doi: 10.1056/NEJM198608073150601.


We compared the efficacy of intravenous gamma globulin plus aspirin with that of aspirin alone in reducing the frequency of coronary-artery abnormalities in children with acute Kawasaki syndrome in a multicenter, randomized trial. Children randomly assigned to the gamma globulin group received intravenous gamma globulin, 400 mg per kilogram of body weight per day, for four consecutive days; both treatment groups received aspirin, 100 mg per kilogram per day, through the 14th day of illness, then 3 to 5 mg per kilogram per day. Two-dimensional echocardiograms were interpreted blindly and independently by two or more readers. Two weeks after enrollment, coronary-artery abnormalities were present in 18 of 78 children (23 percent) in the aspirin group, as compared with 6 of 75 (8 percent) in the gamma globulin group (P = 0.01). Seven weeks after enrollment, abnormalities were present in 14 of 79 children (18 percent) in the aspirin group and in 3 of 79 (4 percent) in the gamma globulin group (P = 0.005). No child had serious adverse effects from receiving gamma globulin. We conclude that high-dose intravenous gamma globulin is safe and effective in reducing the prevalence of coronary-artery abnormalities when administered early in the course of Kawasaki syndrome.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aneurysm / prevention & control
  • Aspirin / administration & dosage
  • Aspirin / therapeutic use
  • Clinical Trials as Topic
  • Coronary Disease / drug therapy
  • Drug Therapy, Combination
  • Echocardiography
  • Female
  • Humans
  • Infant
  • Injections, Intravenous
  • Male
  • Mucocutaneous Lymph Node Syndrome / therapy*
  • Random Allocation
  • gamma-Globulins / administration & dosage*
  • gamma-Globulins / adverse effects


  • gamma-Globulins
  • Aspirin