Department of Pediatrics, Suwa Red Cross Hospital, Suwa, Japan.
Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.
Ther Apher Dial. 2020 Dec;24(6):718-724. doi: 10.1111/1744-9987.13486. Epub 2020 Mar 7.
Plasma exchange is a therapeutic option in refractory Kawasaki disease (KD). However, the effects of other immunosuppressive treatments on plasma exchange therapy have not been studied. We investigated the effect of infliximab on plasma exchange in KD as well as on the outcome in patients with KD. We studied 16 patients with intravenous immunoglobulin-resistant KD who finally underwent plasma exchange. The patients were divided into two groups: patients who received infliximab before plasma exchange (infliximab group) and patients who did not (non-infliximab group). The infliximab group showed a lesser median number of required total plasma exchange sessions (P = .002) and higher change and reduction rates in C-reactive protein before and after the first plasma exchange (both P = .027) than that of the non-infliximab group. Infliximab administered before plasma exchange reduced the number of total plasma exchange sessions and improved the plasma exchange efficacy.
血浆置换是难治性川崎病（KD）的一种治疗选择。然而，尚未研究其他免疫抑制治疗对血浆置换治疗的影响。我们研究了英夫利昔单抗对 KD 中血浆置换的影响以及对 KD 患者结局的影响。我们研究了 16 例静脉注射免疫球蛋白耐药性 KD 患者，这些患者最终接受了血浆置换。这些患者被分为两组：在血浆置换前接受英夫利昔单抗的患者（英夫利昔单抗组）和未接受英夫利昔单抗的患者（非英夫利昔单抗组）。英夫利昔单抗组所需的总血浆置换次数中位数较少（P =.002），并且在第一次血浆置换前后 C 反应蛋白的变化和降低率均高于非英夫利昔单抗组（均 P =.027）。在血浆置换前给予英夫利昔单抗可减少总血浆置换次数，并提高血浆置换疗效。
