Infliximab as a novel therapy for refractory Kawasaki disease.
Kawasaki disease (KD) is a multisystem vasculitis of unknown etiology, with coronary artery aneurysms occurring in 25% of untreated cases. With conventional treatment of intravenous immunoglobulin (i.v.IG) and high dose aspirin (ASA) only 4% of patients develop coronary artery aneurysms. Children who are unresponsive present a challenge. Tumor necrosis factor-alpha levels peak during the acute and subacute phase of KD, especially in children who develop coronary artery aneurysms. We describe a 3-year-old male with KD and giant coronary artery aneurysms, unresponsive to multiple doses of i.v.IG and methylprednisolone, who was treated with infliximab. After the first dose he defervesced and his laboratory measures improved.
Weiss
Jennifer E
JE
Division of Pediatric Cardiology, Department of Pediatrics, Schneider Children's Hospital, North Shore-Long Island Jewish Medical Center, New Hyde Park, New York 11040, USA.
Eberhard
B Anne
BA
Chowdhury
Devyani
D
Gottlieb
Beth S
BS
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D004452:Echocardiography; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000627:therapeutic use*
D000911:Antibodies, Monoclonal; D016756:Immunoglobulins, Intravenous; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D008775:Methylprednisolone