Salguero J Salas, Durán D Gómez-Pastrana, Peracaula C Salido, Iznardi C Ruiz-Berdejo, Tardío J Ortiz
Hospital de Jerez, Jerez de la Frontera, Cádiz, España.
An Pediatr (Barc). 2010 Nov;73(5):268-71. doi: 10.1016/j.anpedi.2010.06.006. Epub 2010 Aug 3.
The classic treatment of Kawasaki disease with immunoglobulin and acetyl salicylic acid obtains a good response in 90% of patients, decreasing the risk of coronary involvement. However, in patients that do not respond to immunoglobulin, it is not clear which therapy should be used: other doses of immunoglobulin, corticosteroids or infliximab. Infliximab is becoming an important second line treatment for Kawasaki refractory to immunoglobulin, although there are few studies and clinical reports with this drug. We present a 5 months-old infant with refractory Kawasaki disease who developed coronary aneurysms despite two immunoglobulin doses and three intravenous pulses-doses of corticosteroids. The infant was finally treated with a single dose of infliximab with good clinical progress.
用免疫球蛋白和乙酰水杨酸对川崎病进行的经典治疗,在90%的患者中能取得良好反应,降低了冠状动脉受累的风险。然而,对于那些对免疫球蛋白无反应的患者,尚不清楚应使用哪种治疗方法:其他剂量的免疫球蛋白、皮质类固醇还是英夫利昔单抗。英夫利昔单抗正成为对免疫球蛋白难治的川崎病的一种重要二线治疗药物,尽管关于这种药物的研究和临床报告很少。我们报告一例5个月大的难治性川崎病婴儿,尽管接受了两剂免疫球蛋白和三剂静脉注射冲击量的皮质类固醇治疗,仍发生了冠状动脉瘤。该婴儿最终接受了单剂量英夫利昔单抗治疗,临床进展良好。