{"title":"泼尼松龙和环孢菌素A联合三线治疗难治性川崎病。","authors":"Masamune Higashigawa, Tomomi Nakamura, Tomoki Hattori, Ayako Yoshino, Mitsue Ito, Ryoji Ichimi","doi":"10.23736/S0026-4946.19.05567-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The selection of drugs as third-line therapy for patients with Kawasaki disease (KD) who are resistant to second-line therapy remains controversial.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sup>th</sup> day of illness.</p><p><strong>Conclusions: </strong>We suggest that the combination of CsA and steroids might be a promising therapeutic strategy for refractory KD.</p>","PeriodicalId":18533,"journal":{"name":"Minerva pediatrica","volume":" ","pages":"682-688"},"PeriodicalIF":2.6000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Combination of prednisolone and cyclosporine A as third-line therapy for refractory Kawasaki disease.\",\"authors\":\"Masamune Higashigawa, Tomomi Nakamura, Tomoki Hattori, Ayako Yoshino, Mitsue Ito, Ryoji Ichimi\",\"doi\":\"10.23736/S0026-4946.19.05567-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The selection of drugs as third-line therapy for patients with Kawasaki disease (KD) who are resistant to second-line therapy remains controversial.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sup>th</sup> day of illness.</p><p><strong>Conclusions: </strong>We suggest that the combination of CsA and steroids might be a promising therapeutic strategy for refractory KD.</p>\",\"PeriodicalId\":18533,\"journal\":{\"name\":\"Minerva pediatrica\",\"volume\":\" \",\"pages\":\"682-688\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Minerva pediatrica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23736/S0026-4946.19.05567-1\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2019/12/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minerva pediatrica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S0026-4946.19.05567-1","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/12/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Combination of prednisolone and cyclosporine A as third-line therapy for refractory Kawasaki disease.
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 60th day of illness.
Conclusions: We suggest that the combination of CsA and steroids might be a promising therapeutic strategy for refractory KD.
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.
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