INFLIXIMAB IN THE TREATMENT OF IMMUNOGLOBULIN-RESISTANT KAWASAKI DISEASE

Q4 Medicine Pediatriya - Zhurnal im G.N. Speranskogo Pub Date : 2023-10-13 DOI:10.24110/0031-403x-2023-102-5-246-251

S.Kh. Kurbanova, L.V. Bregel, M.M. Kurako, A.O. Marandzhian, M.G. Kantemirova, Yu.Yu. Novikova, S.I. Valieva

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Abstract

Kawasaki disease (KD) is an acute systemic disease characterized by predominant damage to small and medium-sized arteries with the development of destructive-proliferative vasculitis, damage to the coronary arteries (CA) and other visceral arteries manifested by fever, changes in the mucous membranes, skin, and lymph nodes. The initial KD therapy is intravenous immunoglobulin (IVIG) at a dose of 2 g/kg coupled with acetylsalicylic acid. However, 10% to 38% may be resistant to standard therapy. There are no uniform recommendations for the management of patients with immunoglobulin-resistant KD. Possible therapies include repeated IVIG, high-dose glucocorticoids, genetically engineered biological drugs and other cytostatic drugs. Authors represent a clinical case of a 4-month-old boy with a complete form of KD, giant CA aneurysms and a resistance to the previous 4 courses of immunomodulatory therapy (2 courses of IVIG, etanercept, pulse therapy with methylprednisolone) with the effective use of the tumor necrosis factor alpha blocker, infliximab.

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英夫利昔单抗治疗免疫球蛋白抵抗性川崎病

川崎病(Kawasaki disease, KD)是一种急性全身性疾病，以中小型动脉损害为主，并发破坏性增殖性血管炎，冠状动脉(CA)和其他内脏动脉损害，表现为发热、粘膜、皮肤和淋巴结改变。最初的KD治疗是静脉注射免疫球蛋白(IVIG)，剂量为2g /kg，与乙酰水杨酸联用。然而，10%至38%的患者可能对标准治疗产生耐药性。对于免疫球蛋白耐药KD患者的治疗尚无统一的建议。可能的治疗方法包括重复IVIG，大剂量糖皮质激素，基因工程生物药物和其他细胞抑制剂药物。作者报告了一个临床病例，一个4个月大的男孩，患有完全形式的KD，巨大的CA动脉瘤，并且对先前4个疗程的免疫调节治疗(2个疗程的IVIG，依那西普，甲基强的松龙脉冲治疗)有抵抗，有效地使用肿瘤坏死因子α阻滞剂英夫利昔单抗。

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

Pediatriya - Zhurnal im G.N. Speranskogo Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

自引率

0.00%

发文量

150

期刊介绍： Journal “Pediatria” named after G.N. Speransky (the official short names of the Journal are “Journal «Pediatria»,” “Pediatria,” and “«Pediatria,» the Journal”) is the oldest Soviet-and-Russian (in the Russian Federation, the CIS and former Soviet Union) scientific and practical medical periodical assigned for pediatricians that is published continuously since May, 1922, and distributed worldwide. Our mission statement specifies that we aim to the ‘raising the level of skills and education of pediatricians, organizers of children’s health protection services, medicine scientists, lecturers and students of medical institutes for higher education, universities and colleges worldwide with an emphasis on Russian-speaking audience and specific, topical problems of children’s healthcare in Russia, the CIS, Baltic States and former Soviet Union Countries and their determination with the use of the World’s best practices in pediatrics.’ As part of this objective, the Editorial of the Journal «Pediatria» named after G.N. Speransky itself adopts a neutral position on issues treated within the Journal. The Journal serves to further academic discussions of topics, irrespective of their nature - whether religious, racial-, gender-based, environmental, ethical, political or other potentially or topically contentious subjects. The Journal is registered with the ISSN, - the international identifier for serials and other continuing resources, in the electronic and print world: ISSN 0031-403X (Print), and ISSN 1990-2182 (Online). The Journal was founded by the Academician, Dr. Georgiy Nestorovich SPERANSKY, in May, 1922. Now (since 1973) the Journal bears his honorary name.