Related Experiment Videos

Treatment of intravenous immunoglobulin-resistant Kawasaki disease with methotrexate

S Y Ahn1, D S Kim

  • 1Department of Paediatrics, College of Medicine, Yonsei University, Seoul, Korea.

Scandinavian Journal of Rheumatology
|August 13, 2005
PubMed
Abstract

Insights

Low-dose oral methotrexate (MTX) effectively treats Kawasaki disease (KD) resistant to standard therapies. This approach rapidly resolves fever and inflammation without adverse effects in refractory cases.

Area of Science:

  • Pediatric Rheumatology
  • Immunology

Background:

  • Kawasaki disease (KD) is a critical pediatric illness.
  • Intravenous immunoglobulin (IVIG) and aspirin are standard treatments.
  • Refractory KD requires alternative therapeutic strategies.

Observation:

  • Four pediatric patients with KD resistant to IVIG and aspirin were studied.
  • Initial treatment included re-administration of IVIG and IV dexamethasone.
  • Dexamethasone provided temporary fever control in most patients.

Findings:

  • Low-dose oral methotrexate (MTX) was administered weekly to all four patients.
  • MTX induced rapid defervescence and clinical improvement in all patients.
  • No coronary artery dilatation progression was observed, and MTX was well-tolerated.

Implications:

  • Low-dose oral MTX is a viable and effective treatment for refractory KD.
  • MTX offers a safe alternative for managing complex pediatric KD cases.
  • Further research into MTX for KD is warranted.

Related Concept Videos

Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Rocky Mountain Spotted Fever01:26

Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...