Select two indications for IV immunoglobulin infusions: (PGI May 2010)
|B||Idiopathic thrombocytopenic purpura|
|C||Option A, B is right|
|D||Hemolytic uremic syndrome|
Kawasaki disease(AIIMS Nov 09)
i. It’s a disease of children below 5 years.
ii. Arteritis involving, medium-sized, or small arteries and associated with mucocutaneous lymph node syndrome.
iii. Coronary arteries are often involved. Aorta and veins may be involved.
iv. Kawasaki disease is an acute febrile multisystem disease of children
v. Prolonged fever over 5 days that is unresponsive to antibiotics is seen.
vi. Although the disease is generally benign &self limiting it is associated with coronary artery aneurysm in 25% of cases.
vii. Non suppurative cervical lymphadenopathy is characteristic.
viii. Strawberry tongue , skin rash & conjunctivitis are the features.
Treatment of Kawasaki disease.
1. Acute phase : As soon as diagnosis is made, ideally <10days of disease onset.
Intravenous immunoglobulin + High dose aspirin.
2. Subacute phase: After day 14 or once the patient is afebrile for 48 – 72 hours
i. Low dose aspirin
ii. Corticosteroids are only recommended for patients who have persistent fever despite at least 2 dose of I/V immunoglobulin.
Extra Edge: Kawasaki disease
1. Characteristic laboratory findings include:
a. Increased ESR b. Thrombocytosis
2. Treatment of choice- High dose intravenous immunoglobulins
3. Prognosis for uneventful recovery is excellent.
Extra Edge: Indications of IV Immunoglobulin therapy
ii. Hypogammaglobulinemia (primary immune deficiencies)
iii. Acquired compromised immunity conditions (secondary immune deficiencies).