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Infliximab treatment for refractory Kawasaki disease with coronary artery aneurysm

Taku Oishi1, Mikiya Fujieda, Taisuke Shiraishi

  • 1Department of Pediatrics, Kochi National Hospital, Kochi, Japan.

Circulation Journal : Official Journal of the Japanese Circulation Society
|April 29, 2008
PubMed

Insights

Tumor necrosis factor-alpha (TNF-alpha) plays a role in Kawasaki disease (KD) with coronary artery aneurysms (CA). Infliximab, an anti-TNF-alpha agent, successfully treated a young patient with refractory KD and CA.

Area of Science:

  • Immunology
  • Pediatrics
  • Cardiology

Background:

  • Kawasaki disease (KD) is an acute febrile vasculitis primarily affecting young children.
  • Coronary artery aneurysms (CA) are a serious complication of KD, linked to inflammatory processes.
  • Elevated levels of Tumor Necrosis Factor-alpha (TNF-alpha) are observed in KD patients with CA.

Observation:

  • A 1-month-old infant presented with refractory KD complicated by CA.
  • The patient received treatment with infliximab, an anti-TNF-alpha biologic agent.
  • Clinical assessment focused on the resolution of CA and control of KD symptoms.

Findings:

  • Infliximab administration led to the improvement of coronary artery aneurysms.
  • The patient's Kawasaki disease was effectively controlled following treatment.
  • Symptom resolution and absence of complications were noted 20 months post-onset.

Implications:

  • This case suggests TNF-alpha inhibition is a potential therapeutic strategy for refractory KD with CA.
  • Targeting TNF-alpha may prevent or reverse vascular damage in KD.
  • Further research into anti-TNF-alpha agents for KD management is warranted.

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