Weiss Jennifer E, Eberhard B Anne, Chowdhury Devyani, Gottlieb Beth S
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.
J Rheumatol. 2004 Apr;31(4):808-10.
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.
川崎病（KD）是一种病因不明的多系统血管炎，在未经治疗的病例中，25%会出现冠状动脉瘤。采用静脉注射免疫球蛋白（i.v.IG）和高剂量阿司匹林（ASA）的传统治疗方法，只有4%的患者会发生冠状动脉瘤。无反应的儿童是一个挑战。肿瘤坏死因子-α水平在KD的急性期和亚急性期达到峰值，尤其是在发生冠状动脉瘤的儿童中。我们描述了一名3岁男性患有KD和巨大冠状动脉瘤，对多剂量i.v.IG和甲基强的松龙无反应，接受了英夫利昔单抗治疗。首次给药后，他退热，实验室指标改善。
