Pulse methylprednisolone therapy in the treatment of immune globulin-resistant Kawasaki disease: case report and review of the literature.
A subgroup of patients with Kawasaki disease (KD) did not respond to intravenous immune globulin (IVIG) therapy. Corticosteroid therapy remains a controversial alternative in such cases. We report two young children with KD who failed to respond to three courses of IVIG therapy and subsequently received pulse methylprednisolone as an alternative. One had a satisfactory outcome but the other developed giant coronary aneurysms and had a myocardial infarction 2 months after onset of the illness. A review of relevant literature showed that the timing of initiation of pulse methylprednisolone therapy is important. It is suggested that pulse methylprednisolone therapy should be considered if there is no response to two standard doses of IVIG treatment.
Department of Pediatrics, Chang Gung Children's Hospital, Kweishan, Taoyuan, Taiwan.
Jeng-Juh
JJ
Hung
Cheng-Hsun
CH
Chiu
D002675:Child, Preschool; D004351:Drug Resistance; D005938:Glucocorticoids / Q000008:administration & dosage*; D006322:Heart Aneurysm / Q000150:complications; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000188:drug therapy*; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome
D005938:Glucocorticoids; D007136:Immunoglobulins; D008775:Methylprednisolone