Neutropenia in Kawasaki disease

✍ Scribed by T. Hara; Y. Mizuno; K. Ueda; H. Akeda; T. Aoki; S. Honda; Y. Yamaguchi; T. Hosoyamada

• Publisher: Springer
• Year: 1989
• Tongue: English
• Weight: 118 KB
• Volume: 148
• Category: Article
• ISSN: 0340-6997
• DOI: 10.1007/bf00441566

✦ Synopsis

In our experience, 7 out of 13 children with AIDS developed PCP, 5 of which died rapidly after the onset of symptoms. The other 2 children were treated with TMP-SMZ and steroids. The first child, aged 6 months, PaO2 < 50 mmHg, was given oral prednisone (2 mg/kg per day) for 1 month.

The second child, aged 11 months, PaOz <50mmHg, after 10 days of i.v. TMP-SMZ without any improvement, was given methylprednisolone i.v. (Smg/kg per day) for 5 consecutive days and then oral prednisone (0.5 mg/kg per day) for 1 month. Both infants showed an immediate increase in PaO2 values up to 100mmHg and a rapid clinical and radiological improvement. The second infant is still in good condition after 6 months, whereas the first relapsed 1 year later. He was then treated with TMP-SMZ plus methylprednisolone i.v. (20 rag/ kg per day) for 3 consecutive clays and subsequently with oral prednisone (0.5 mg/kg per day) for 1 month.

Although steroids cannot be recommended as a routine or accepted treatment in PCP, they may be of use in cases with severe respiratory distress and poor response to conventional therapy. Controlled trials to determine their real efficacy, the dose and the route of administration are needed.