Bibiana Marriaga-Núñez, Araceli Arellano-Valdez, Juan P Abarca-de la Paz, Miguel A Bonal-Pérez, Jesús G Montaño-Durón, Fortino Solórzano-Santos
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Background: Kawasaki disease is a systemic vasculitis that affects small and medium-sized vessels, primarily the coronary arteries. First-line treatment includes intravenous immunoglobulin (IVIG) and acetylsalicylic acid; however, 20% do not respond adequately despite treatment. We describe a case treated with etanercept after initial IVIG failure, showing a good response.
Case report: A 5-year-old female was diagnosed with classic Kawasaki disease. Echocardiography and angiotomography revealed giant and fusiform aneurysms in the coronary arteries. A first dose of IVIG therapy was administered without improvement; after the second dose, the fever persisted, so etanercept was administered, and the fever subsided. There were no new lesions in medium-caliber vessels and the previously identified coronary lesions did not progress.
Conclusions: The use of etanercept in Kawasaki disease has demonstrated a clinically favorable response. Controlled clinical trials of this drug are needed to establish it as a formal therapy in cases of initial IVIG failure.
期刊介绍：
The Boletín Médico del Hospital Infantil de México is a bimonthly publication edited by the Hospital Infantil de México Federico Gómez. It receives unpublished manuscripts, in English or Spanish, relating to paediatrics in the following areas: biomedicine, clinical, public health, clinical epidemology, health education and clinical ethics. Articles can be original research articles, in-depth or systematic reviews, clinical cases, clinical-pathological cases, articles about public health, letters to the editor or editorials (by invitation).
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