title: Infliximab plus plasma exchange rescue therapy in Kawasaki disease.
abstract: OBJECTIVE
  To evaluate infliximab (IFX) in patients with Kawasaki disease (KD) that was unresponsive to additional intravenous immunoglobulin (IVIG) therapy and subsequent rescue with supplementary plasma exchange (PE) in patients unresponsive to treatment.
  
  
  METHODS
  We studied 76 patients with KD who received IVIG therapy twice and were unresponsive to additional IVIG.
  
  
  RESULTS
  Seventy were treated with IFX alone (92.1%). Six patients who were unresponsive IFX (7.9%) were further treated by PE. This resulted in disappearance of fever and other clinical symptoms, and improvement of laboratory data. There was no severe life-threatening adverse events.Twelve of the 76 cases had developed coronary artery dilatation, and 3 had coronary artery aneurysm within 1 month of disease onset. At the end of follow-up, in all cases, coronary artery lesions were suppressed or reversed.
  
  
  CONCLUSIONS
  Treatment of intractable KD with sequential IVIG, IFX, and PE treatments in a step-wise protocol was effective.
authors.affiliation: Department of Pediatrics, Yokohama City University, School of Medicine Yokohama, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Sonoda
authors.affiliation: Department of Pediatrics, Yokohama City University Medical Center, Yokohama, Japan. Electronic address: mmori@med.yokohama-cu.ac.jp.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Mori
authors.affiliation: Department of Pediatrics, Yokohama City University, School of Medicine Yokohama, Japan.
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Hokosaki
authors.affiliation: Department of Pediatrics, Yokohama City University, School of Medicine Yokohama, Japan.
authors.forename: Shumpei
authors.initials: S
authors.lastname: Yokota
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D000069285:Infliximab; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000628:therapy*; D010951:Plasma Exchange; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D000069285:Infliximab