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Abstract：
BACKGROUND: We have reviewed four cases of Kawasaki disease treated with plasma exchange with 5% albumin in electrolyte-balanced solution, according to the recommended guidelines for Kawasaki disease in the intensive care unit, as their responses to intravenous immunoglobulin therapy were poor.
METHODS: The four cases were aged between 5 months and 3 years and weighted between 6.4 and 15.6 kg. The plasma levels of C-reactive protein were significantly decreased after plasma exchange (p < 0.05). The dilatations of the coronary artery were found in two cases, but both of them were ameliorated until 1 month after the onset and the other cases recovered without any complications. However, we recognized that one case showed marked decreases in coagulation factors, especially in fibrinogen after each plasma exchange even with a transfusion of fresh frozen plasma.
CONCLUSIONS: Plasma exchange with 5% albumin was effective for refractory Kawasaki disease. However, as there was a possibility of coagulation disorder, attention should be given to changes in coagulation factors like fibrinogen, especially in small patients who need frequent plasma exchange.
METHODS: The four cases were aged between 5 months and 3 years and weighted between 6.4 and 15.6 kg. The plasma levels of C-reactive protein were significantly decreased after plasma exchange (p < 0.05). The dilatations of the coronary artery were found in two cases, but both of them were ameliorated until 1 month after the onset and the other cases recovered without any complications. However, we recognized that one case showed marked decreases in coagulation factors, especially in fibrinogen after each plasma exchange even with a transfusion of fresh frozen plasma.
CONCLUSIONS: Plasma exchange with 5% albumin was effective for refractory Kawasaki disease. However, as there was a possibility of coagulation disorder, attention should be given to changes in coagulation factors like fibrinogen, especially in small patients who need frequent plasma exchange.
摘要：
背景：我们回顾了4例使用电解质平衡溶液中5％白蛋白的血浆置换治疗的川崎病，根据重症监护病房川崎病的推荐指南，因为他们对静脉注射免疫球蛋白治疗的反应很差。
方法：4例患者年龄在5个月至3岁之间，体重在6.4至15.6kg之间。血浆置换后血浆C反应蛋白水平明显下降(p<0.05)。两例患者出现冠状动脉扩张,但两者均在发病后1个月前得到改善，其他病例均无任何并发症。然而,我们认识到一例显示凝血因子明显减少，尤其是在每次血浆置换后的纤维蛋白原中，即使输注新鲜的冷冻血浆也是如此。
结论：5%白蛋白血浆置换治疗难治性川崎病有效。然而,因为有凝血障碍的可能性，应注意凝血因子如纤维蛋白原的变化，尤其是需要频繁血浆置换的小患者。
方法：4例患者年龄在5个月至3岁之间，体重在6.4至15.6kg之间。血浆置换后血浆C反应蛋白水平明显下降(p<0.05)。两例患者出现冠状动脉扩张,但两者均在发病后1个月前得到改善，其他病例均无任何并发症。然而,我们认识到一例显示凝血因子明显减少，尤其是在每次血浆置换后的纤维蛋白原中，即使输注新鲜的冷冻血浆也是如此。
结论：5%白蛋白血浆置换治疗难治性川崎病有效。然而,因为有凝血障碍的可能性，应注意凝血因子如纤维蛋白原的变化，尤其是需要频繁血浆置换的小患者。
