A 2-Year-Old Boy With Refractory Kawasaki Disease Who Developed a Giant Aneurysm After Successful Treatment With Infliximab
| Autor: | Saki Endo, Setsuko Kitaoka, Masato Kimura, Hisao Yaoita, Ryouichi Oonuma, Chiharu Ota |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Aspirin business.industry Ulinastatin medicine.disease Gastroenterology Infliximab chemistry.chemical_compound chemistry Refractory hemic and lymphatic diseases Internal medicine Prednisolone Medicine Kawasaki disease business Complication medicine.drug Systemic vasculitis |
| Zdroj: | International Journal of Clinical Pediatrics. 8:45-50 |
| ISSN: | 1927-1263 1927-1255 |
| Popis: | Kawasaki disease (KD) is the leading cause of systemic vasculitis syndrome in infants and in young children, although its cause has still not been elucidated. Coronary aneurysm (CA) is a major and important complication of KD. Patients resistant to intravenous immunoglobulin (IVIG) treatment are at a high risk of CA. Infliximab (IFX) is a chimeric monoclonal antibody that specifically binds to tumor necrosis factor-alpha (TNF-alpha) and has been successfully used in some cases of IVIG-refractory KD. However, optimal timing for the administration of IFX has not yet been determined. We present a case of a 2-year-old boy with IVIG-refractory KD who developed a giant right coronary artery (RCA) aneurysm after successful treatment with IFX. Treatment with IVIG (2 g/kg), prednisolone (PSL, 2 mg/kg/day), and aspirin (50 mg/kg/day) was initiated on day 2 because of the fulfillment of KD criteria. Additional IVIG (2 g/kg) and ulinastatin (20,000 U/kg) treatment on day 5 and intravenous administration of IFX (5 mg/kg) on day 9 effectively lowered the patient ’s fever and improved laboratory data. However, the RCA continued to balloon into a giant CA, from 7.3 mm on day 9 to 14.3 mm in diameter at 2 months. IFX is one treatment option for IVIG-refractory KD. However, the timing and indication of IFX treatment should be carefully determined. Int J Clin Pediatr. 2019;8(2):45-50 doi: https://doi.org/10.14740/ijcp345 |
| Databáze: | OpenAIRE |
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