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Infliximab treatment for a patient with refractory Kawasaki disease  

Yu, Hyo-Jung (Department of Pediatrics, College of Medicine, Ewha Womans University)
Lee, Soo-Jin (Department of Pediatrics, College of Medicine, Ewha Womans University)
Sohn, Sejung (Department of Pediatrics, College of Medicine, Ewha Womans University)
Publication Information
Clinical and Experimental Pediatrics / v.49, no.9, 2006 , pp. 987-990 More about this Journal
Abstract
Intravenous immunoglobulin (IVIG) infusion is an effective therapy for acute Kawasaki disease (KD). Nonetheless, approximately 10 percent to 20 percent of patients have persistent or recrudescent fever despite IVIG treatment, leading to a higher risk for coronary artery aneurysms (CAA). This unresponsiveness may pose a challenge to the clinicians. Tumor necrosis $factor-{\alpha}$ levels are elevated in the acute phase of the disease, especially in patients who develop CAA. We report a 10-month-old male with KD who failed to respond to multiple doses of IVIG and methylprednisolone and who then was treated with infliximab (5 mg/kg single dose). After infliximab treatment, he became afebrile with normalization of inflammatory markers and no further progression of CAA.
Keywords
Mucocutaneous lymph node syndrome; Tumor necrosis $factor-{\alpha}$; Infliximab;
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1 Lee MS, An SY, Jang GC, Kim DS. A case of intravenous immunoglobulin-resistant Kawasaki disease treated with methotrexate. Yonsei Med J 2002;43:527-32   DOI
2 Burns JC, Mason WH, Hauger SB, Janai H, Bastian JF, Wohrley JD, et al. Infliximab treatment for refractory Kawasaki syndrome. J Pediatr 2005;146:662-7   DOI   ScienceOn
3 de Zorzi A, Colan SD, Gauvreau K, Baker AL, Sundel RP, Newburger JW. Coronary artery dimensions may be misclassified as normal in Kawasaki disease. J Pediatr 1998;133:254-8   DOI   ScienceOn
4 Shim SY, Heo MY, Kim HS, Sohn S. High-dose intravenous immune globulin retreatment in Kawasaki disease. J Korean Pediatr Soc 2002;45:1273-7
5 Newburger JW, Takahashi M, Burns JC, Beiser AS, Chung KJ, Duffy CE, et al. The treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med 1986;315:341-7   DOI   ScienceOn
6 Leung DY, Geha RS, Newburger JW, Burns JC, Fiers W, Lapierre LA, et al. Two monokines, interleukin 1 and tumor necrosis factor, render cultured vascular endothelial cells susceptible to lysis by antibodies circulating during Kawasaki syndrome. J Exp Med 1986;164:1958-72   DOI
7 Lee H, Kim H, Kim HS, Sohn S. NT-proBNP : a new diagnostic screening tool for Kawasaki disease. Korean J Pediatr In press 2006   DOI
8 Burns JC, Capparelli EV, Brown JA, Newburger JW, Glode MP. Intravenous gamma-globulin treatment and retreatment in Kawasaki disease. US/Canadian Kawasaki Syndrome Study Group. Pediatr Infect Dis J 1998;17:1144-8   DOI   ScienceOn
9 Sundel RP, Burns JC, Baker A, Beiser AS, Newburger JW. Gamma globulin re-treatment in Kawasaki disease. J Pediatr 1993;123:657-9   DOI   ScienceOn
10 Knight DM, Trinh H, Le J, Siegel S, Shealy D, Mc-Donough M, et al. Construction and initial characterization of a mouse-human chimeric anti-TNF antibody. Mol Immunol 1993;30:1443-53   DOI   ScienceOn
11 Weiss JE, Eberhard BA, Chowdhury D, Gottlieb BS. Infliximab as a novel therapy for refractory Kawasaki disease. J Rheumatol 2004;31:808-10
12 Wallace CA, French JW, Kahn SJ, Sherry DD. Initial intravenous gammaglobulin treatment failure in Kawasaki disease. Pediatrics 2000;105:E78   DOI   ScienceOn
13 Wright DA, Newburger JW, Baker A, Sundel RP. Treatment of immune globulin-resistant Kawasaki disease with pulsed doses of corticosteroids. J Pediatr 1996;128:146-9   DOI   ScienceOn
14 Imagawa T, Mori M, Miyamae T, Ito S, Nakamura T, Yasui K, et al. Plasma exchange for refractory Kawasaki disease. Eur J Pediatr 2004;163:263-4   DOI
15 Matsubara T, Furukawa S, Yabuta K. Serum levels of tumor necrosis factor, interleukin 2 receptor, and interferon-$\gamma$ in Kawasaki disease involved coronary-artery lesions. Clin Immunol Immunopathol 1990;56:29-36   DOI   ScienceOn