Efficacy and safety of plasma exchange for Kawasaki disease with coronary artery dilatation
| Autor: | Hidemi Nishida, Yoshimi Takamiya, Ryo Yamamoto, Shintaro Kishimoto, Seiya Okuda, Yusuke Koteda, Ryo Shibata, Kenji Suda, Takatoshi Kambe, Takuma Hazama, Yusuke Kaida, Kei Fukami, Tetsurou Imai |
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| Rok vydání: | 2017 |
| Předmět: |
Nephrology
medicine.medical_specialty Urology 030204 cardiovascular system & hematology Coronary artery lcsh:RC870-923 Asymptomatic 03 medical and health sciences 0302 clinical medicine Intravenous Immunoglobulin Therapy Aneurysm Internal medicine Plasma exchange Medicine 030212 general & internal medicine Transplantation Kawasaki disease business.industry lcsh:Diseases of the genitourinary system. Urology medicine.disease Surgery Stenosis medicine.anatomical_structure Cardiology Prednisolone medicine.symptom business medicine.drug Artery |
| Zdroj: | Renal Replacement Therapy, Vol 3, Iss 1, Pp 1-6 (2017) |
| ISSN: | 2059-1381 |
| Popis: | Background The treatment of Kawasaki disease is controversial when intravenous immunoglobulin therapy fails, although it typically relies on combinations of prednisolone, infliximab, cyclosporine, and plasma exchange therapy. The goal of the treatment is no longer merely to reduce mortality but also to decrease the sequelae of coronary artery lesions, which are the most common and potentially life-threatening complications. Recently, plasma exchange therapy has been used to treat intravenous immunoglobulin-unresponsive Kawasaki disease with coronary artery lesions. When performed before coronary artery dilatation, the outcomes for plasma exchange are known to be excellent; however, when dilatation is already present, sequelae persist. Methods Between December 2006 and April 2015, we treated ten patients with Kawasaki disease complicated by coronary artery lesions that received plasma exchange because intravenous immunoglobulin therapy had proven to be ineffective. Here, we retrospectively review the efficacy and safety of plasma exchange therapy in such unresponsive cases against coronary artery lesions in patients with Kawasaki disease when plasma exchange performed after coronary artery dilatation. Results In nine of the ten patients (90.0%), the body temperature was confirmed to be |
| Databáze: | OpenAIRE |
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