Abstract
Harada score, which was originally constructed as a guideline for indication of intravenous gamma globulin (IVGG) in research group of Kawasaki disease promoted by the Ministry of Health (Kouseishou), had been applied to consecutive 258 cases of Kawasaki disease between 1989 and 1998. Each item of score are regarded as positive when patient is male, 12-month-old or younger, white blood cell count is 12,000/mm3 or more, platelet count is less than 350,000/mm4C-reactive protein is 4.0mg/dl or more, hematocrit is less than 35%, serum albumin is less than 3.5g/dl. Concerning to these items, 203 cases (78.7%) fulfilled 4 or more items and were treated with IVGG. Among them, coronary artery lesion (CAL) developed in 28 cases (13.8%) at 30th day after onset and remained after 1 year in 19 cases (7.4%). Giant aneurysm larger than 8mm in diameter developed in 3 cases (1.5%). Fifty-five cases fulfilled 3 or fewer items and were not treated with IVGG. CAL developed in 2 cases (3.6%) at 30th day and both of them regressed to discontinue medication until 1 year after onset. Frequency of blood examinations while patient is in hospital were done every 3.13±0.87 days in cases during 3 years from 1986 to 1988 before Harada score was evaluated, while during 10 years of this study examinations were done every 3.06±0.46 days in cases that IVGG was indicated, and 2.81±0.68 days in cases that IVGG was not indicated. Harada score has utility with 93.3% and 100% of sensitivity at 30th day and over 1 year respectively, for selection of cases which IVGG is absolutely necessary for prevention of CAL. Though frequency of blood tests tends to increase, statistics concerning to it was not significant.
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Ayusawa, M., Kanamaru, H., Karasawa, K. et al. Estimation of “Selective” Intravenous Gamma Globulin Treatment Indicated by Harada Score. Pediatr Res 53, 181 (2003). https://doi.org/10.1203/00006450-200301000-00166
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DOI: https://doi.org/10.1203/00006450-200301000-00166
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