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A report of two cases of Kawasaki disease treated with plasma exchange

Tomonori Harada1, Shuichi Ito, Kentaro Shiga

  • 1Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan. haradat@mbd.ocn.ne.jp

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|April 5, 2008
PubMed

Insights

Plasma exchange may improve outcomes for Kawasaki disease patients unresponsive to IVIG, potentially reducing coronary artery lesions and treating shock-induced heart failure.

Area of Science:

  • Pediatric Rheumatology
  • Vasculitis Research
  • Cardiovascular Medicine

Background:

  • Kawasaki disease is a vasculitis affecting young children, with coronary artery lesions being a major concern.
  • Intravenous immunoglobulin (IVIG) is standard early treatment, but some patients show resistance.
  • Acute heart failure is an uncommon but severe complication.

Observation:

  • Two cases of Kawasaki disease with persistent fever and shock post-IVIG are presented.
  • These patients experienced acute heart failure and catecholamine-refractory shock.
  • Plasma exchange was administered to both patients.

Findings:

  • Plasma exchange may have reduced the risk of coronary artery lesions in these non-responsive cases.
  • The treatment appeared effective in managing acute heart failure and shock.
  • The precise mechanism behind plasma exchange's efficacy in these scenarios requires further investigation.

Implications:

  • Plasma exchange could be a valuable therapeutic option for refractory Kawasaki disease.
  • Further research is needed to elucidate the mechanisms and confirm efficacy.
  • This approach may offer a strategy to mitigate severe cardiovascular complications in difficult-to-treat pediatric vasculitis.

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