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Research ArticlePediatric Rheumatology

Efficacy and Limitation of Infliximab Treatment for Children with Kawasaki Disease Intractable to Intravenous Immunoglobulin Therapy: Report of an Open-label Case Series

MASAAKI MORI, TOMOYUKI IMAGAWA, RYOKI HARA, MASAKO KIKUCHI, TAKUMA HARA, TOMO NOZAWA, TAKAKO MIYAMAE and SHUMPEI YOKOTA
The Journal of Rheumatology April 2012, 39 (4) 864-867; DOI: https://doi.org/10.3899/jrheum.110877
MASAAKI MORI
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  • For correspondence: mmori{at}med.yokohama-cu.ac.jp
TOMOYUKI IMAGAWA
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RYOKI HARA
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MASAKO KIKUCHI
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TAKUMA HARA
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TOMO NOZAWA
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TAKAKO MIYAMAE
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SHUMPEI YOKOTA
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    Figure 1.

    Course of patients’ body temperature: maximum temperature in 1 day was monitored every day before and after infliximab infusion. Eighteen patients showed rapid decreases of fever within 24 hours after infliximab infusion. However, fluctuations of body temperature were noted in 2 patients. PE: plasma exchange.

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    Figure 2.

    Clinical data results. A. Symptoms: 18 patients with 5 or 6 major symptoms of Kawasaki disease at enrollment showed gradual decreases of these symptoms within 3 days after infliximab administration. B. White blood cell (WBC) counts: treatment resulted in rapid decreases of WBC within 2 to 3 days in those who responded to infliximab, assessed by fever and clinical symptoms. C. C-reactive protein (CRP): treatment provided rapid decreases of CRP within 2 to 3 days in those who were responders to infliximab, assessed by fever and clinical symptoms.

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    Table 1.

    Baseline characteristics of patients with Kawasaki disease (KD). Data are mean (range) unless otherwise indicated.

    Characteristic
    Age, yrs4.6 (1.9–10.5)
    Sex, male/female10/10
    Fulfillment of KD criteria5/6: 5 cases
    6/6: 15 cases
    Day receiving initial IVIG4.3 (3–6)
    Dose of initial IVIG, g/kg3.6 (3–4)
    Other medications, no. cases
      ASA12
      Flurbiprofen8
      Ulinastatin2
    Symptoms of KD before IFX
      Fever, °C39.1 (38.4–40.5)
      Bilateral bulbar conjunctival injection20 cases
      Changes in lips and oral cavity20 cases
      Cervical lymphadenopathy20 cases
      Polymorphous exanthema15 cases
      Change in extremities20 cases
    Laboratory findings before IFX
      White blood cell count, per μl17,304 (8,400–30,600)
      Neutrophil count, %75.6 (50.5–91.7)
      Platelet count, (× 104/μl)43.0 (18.9–76.1)
      Serum albumin, g/dl2.30 (1.6–3.1)
      C-reactive protein, mg/dl14.8 (5.0–36.8)
      Coronary abnormalities20 cases
    • IVIG: intravenous immunoglobulin; IFX: infliximab; ASA: acetylsalicylic acid.

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The Journal of Rheumatology
Vol. 39, Issue 4
1 Apr 2012
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Efficacy and Limitation of Infliximab Treatment for Children with Kawasaki Disease Intractable to Intravenous Immunoglobulin Therapy: Report of an Open-label Case Series
MASAAKI MORI, TOMOYUKI IMAGAWA, RYOKI HARA, MASAKO KIKUCHI, TAKUMA HARA, TOMO NOZAWA, TAKAKO MIYAMAE, SHUMPEI YOKOTA
The Journal of Rheumatology Apr 2012, 39 (4) 864-867; DOI: 10.3899/jrheum.110877

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Efficacy and Limitation of Infliximab Treatment for Children with Kawasaki Disease Intractable to Intravenous Immunoglobulin Therapy: Report of an Open-label Case Series
MASAAKI MORI, TOMOYUKI IMAGAWA, RYOKI HARA, MASAKO KIKUCHI, TAKUMA HARA, TOMO NOZAWA, TAKAKO MIYAMAE, SHUMPEI YOKOTA
The Journal of Rheumatology Apr 2012, 39 (4) 864-867; DOI: 10.3899/jrheum.110877
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