OBJECTIVE To conduct a meta-analysis of evidence from randomized controlled trails (RCTs) of different doses of Intravenous Immunoglobulin (IVIG) in children with severe hand, foot and mouth disease (HFMD) to provide the scientific basis for clinical practice. METHODS A search of PubMed-Medline, CNKI, Wanfang, and VIP database (until 30 June 2017) was performed and Software RevMan5.3 was used to evaluate
the effect of different doses of IVIG on HFMD in RCTs, We used random effects models (or fixed effects models) and generic inverse variance methods to process quantitative data, followed by a leave-one-out method for sensitivity analysis. RESULTS From a total of 420 entries identified via searches, 8 RCTs involving 1450 patients were included in the final analysis. The results of the meta-analysis showed that compared with conventional therapy alone, conventional therapy combined with IVIG had shorter fever clearance time, shorter rash regression time and shorter clinical cure time. Subgroup analyses showed that the high-dose group (1g/kg per day) had shorter fever clearance time (p < 0.05), shorter rash regression (p < 0.05), shorter remission time of neurological symptoms (p < 0.05), but longer clinical cure time (p > 0.05). CONCLUSION The high-dose group has a better prognosis, however, the advantages and disadvantages should be carefully considered when deciding the doses in the treatment of severe HFMD.