Combination of prednisolone and cyclosporine A as third-line therapy for refractory Kawasaki disease.

IF 2.6 4区医学 Q2 Medicine

Minerva pediatrica Pub Date : 2023-10-01 Epub Date: 2019-12-11 DOI:10.23736/S0026-4946.19.05567-1

Masamune Higashigawa, Tomomi Nakamura, Tomoki Hattori, Ayako Yoshino, Mitsue Ito, Ryoji Ichimi

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引用次数: 1

Abstract

Background: The selection of drugs as third-line therapy for patients with Kawasaki disease (KD) who are resistant to second-line therapy remains controversial.

Methods: We reviewed the medical records of 354 patients (216 males/137 females) with KD who were treated in our department from July 2003 to January 2016. The age range was 1 month to 10 years, and the median age was 2 years and 1 month. A combination of 2 g/kg intravenous immunoglobulin (IVIG) plus 30 mg/kg of aspirin was used as first-line therapy. Patients who were refractory to the first-line therapy were administered 2 mg/kg of prednisolone (PSL) in combination with IVIG. Five patients who were refractory to the second-line therapy were treated with cyclosporine A (CsA) combined with PSL as the third-line therapy.

Results: All five patients immediately responded to the third-line therapy. One of the five patients showed a transient dilatation of the coronary artery that regressed to its normal size by the 60^th day of illness.

Conclusions: We suggest that the combination of CsA and steroids might be a promising therapeutic strategy for refractory KD.

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泼尼松龙和环孢菌素A联合三线治疗难治性川崎病。

背景：选择药物作为对二线治疗有耐药性的川崎病（KD）患者的三线治疗仍然存在争议。方法：我们回顾了2003年7月至2016年1月在我科接受治疗的354名KD患者（216名男性/137名女性）的病历。年龄范围为1个月至10岁，中位年龄为2岁零1个月。使用2 g/kg静脉注射免疫球蛋白（IVIG）加30 mg/kg阿司匹林的组合作为一线治疗。对一线治疗难治的患者给予2 mg/kg泼尼松（PSL）联合IVIG。五名对二线治疗难治的患者接受了环孢菌素A（CsA）联合PSL作为三线治疗。结果：所有5名患者均立即对三线治疗做出反应。五名患者中有一人出现短暂的冠状动脉扩张，在患病第60天恢复到正常大小。结论：CsA和类固醇联合治疗难治性KD可能是一种有前景的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minerva pediatrica PEDIATRICS-

CiteScore

2.70

自引率

3.80%

发文量

审稿时长

>12 weeks

期刊介绍： Minerva Pediatrica publishes scientific papers on pediatrics, neonatology, adolescent medicine, child and adolescent psychiatry and pediatric surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.