Details

Autor(en) / Beteiligte

• Burns, Jane C.
• Mason, Wilbert H.
• Hauger, Sarmistha B.
• Janai, Hillel
• Bastian, John F.
• Wohrley, Julie D.
• Balfour, Ian
• Shen, Cynthia A.
• Michel, Edward D.
• Shulman, Stanford T.
• Melish, Marian E.

Titel

Infliximab treatment for refractory Kawasaki syndrome

Ist Teil von

• The Journal of pediatrics, 2005-05, Vol.146 (5), p.662-667

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

2005

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• To evaluate the use of tumor necrosis factor (TNF)-α blockade for treatment of patients with Kawasaki syndrome (KS) who fail to become afebrile or who experience persistent arthritis after treatment with intravenous gamma globulin (IVIG) and high-dose aspirin. Cases were retrospectively collected from clinicians throughout the United States who had used infliximab, a chimeric murine/human immunoglobulin (Ig)G1 monoclonal antibody that binds specifically to human TNF-α-1, for patients with KS who had either persistent arthritis or persistent or recrudescent fever ≥48 hours following infusion of 2 g/kg of IVIG. Response to therapy with cessation of fever occurred in 13 of 16 patients. C-reactive protein (CRP) level was elevated in all but one patient before infliximab infusion, and the level was lower following infusion in all 10 patients in whom it was re-measured within 48 hours of treatment. There were no infusion reactions to infliximab and no complications attributed to infliximab administration in any of the patients. The success of TNF-α blockade in this small series of patients suggests a central role of TNF-α in KS pathogenesis. Controlled, randomized clinical trials are warranted to determine the role of anti-TNF-α therapy in KS.