Korean J Pediatr.  2006 Sep;49(9):987-990. 10.3345/kjp.2006.49.9.987.

Infliximab treatment for a patient with refractory Kawasaki disease

• Yu HJ
• Lee SJ
• Sohn S

• KMID: 2278534
• DOI: http://doi.org/10.3345/kjp.2006.49.9.987

Abstract

Intravenous immunoglobulin (IVIG) infusion is an effective therapy for acute Kawasaki disease (KD). Nonetheless, approximately 10 percent to 20 percent of patients have persistent or recrudescent fever despite IVIG treatment, leading to a higher risk for coronary artery aneurysms (CAA). This unresponsiveness may pose a challenge to the clinicians. Tumor necrosis factor-alpha levels are elevated in the acute phase of the disease, especially in patients who develop CAA. We report a 10-month-old male with KD who failed to respond to multiple doses of IVIG and methylprednisolone and who then was treated with infliximab (5 mg/kg single dose). After infliximab treatment, he became afebrile with normalization of inflammatory markers and no further progression of CAA.

Keyword

Mucocutaneous lymph node syndrome; Tumor necrosis factor-alpha; Infliximab

MeSH Terms

Aneurysm
Coronary Vessels
Fever
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Infant
Male
Methylprednisolone
Mucocutaneous Lymph Node Syndrome*
Tumor Necrosis Factor-alpha
Infliximab
Immunoglobulins
Immunoglobulins, Intravenous
Methylprednisolone
Tumor Necrosis Factor-alpha