All issues > Volume 49(9); 2006

Case Report

Korean J Pediatr. 2006;49(9):987-990. Published online September 15, 2006.

Infliximab treatment for a patient with refractory Kawasaki disease

Hyo-Jung HJ Yu¹, Soo-Jin SJ Lee¹, Sejung SJ Sohn¹

¹Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea

Correspondence Sejung SJ Sohn ,Email: sohn@ewha.ac.kr

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-α 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.

Keywords :Mucocutaneous lymph node syndrome , Tumor necrosis factor-α , Infliximab