Antioxidants may mitigate the deterioration of coronary arteritis in patients with Kawasaki disease unresponsive to high-dose intravenous gamma-globulin.
During the early stages of Kawasaki disease, a marked increase in oxygen-free-radicals (OFRs), which are produced by activated polymorphonuclear cells, may induce coronary arteritis. Early use of high-dose intravenous gamma-globulin (IVIG) and aspirin effectively blocked this deteriorating course of coronary arteritis; however, late use of IVIG, even using a high-dose schedule, did not achieve the same efficacy. The causes and reactions to the scenario of IVIG refractoriness have rarely been mentioned in the literature. We present an 11-month-old male infant with Kawasaki disease and deteriorating coronary arteritis owing to late use of IVIG who showed dramatic responsiveness to the addition of alpha-tocopherol and ascorbic acid. We also discuss the possible mechanism.
Shen
C T
CT
Department of Pediatrics, Cathay General Hospital, 280 Jen-Ai- Road, Section 4, Taipei, Taiwan. ctsf0901@tpts5.seed.net.tw
Wang
N K
NK
D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004452:Echocardiography; D006801:Humans; D007116:Immunization, Passive; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000008:administration & dosage*
D000975:Antioxidants; D024502:alpha-Tocopherol; D001205:Ascorbic Acid