Management of coronary artery aneurysms using abciximab in children with Kawasaki disease
Evangelia Bachlava1, Sophia Loukopoulou1, Evangelos Karanasios2
1First Department of Pediatrics, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.
Insights
Abciximab shows promise in treating severe cardiac issues in children with Kawasaki disease (KD) unresponsive to standard care. Most patients experienced resolution or regression of coronary artery abnormalities after treatment.
Area of Science:
- Pediatric Cardiology
- Immunology
- Pharmacology
Background:
- Kawasaki disease (KD) can lead to severe cardiac complications, particularly in children unresponsive to conventional therapies.
- Limited data exists on the efficacy of abciximab for managing cardiac abnormalities in pediatric KD patients.
Purpose of the Study:
- To evaluate the potential benefits of abciximab in children diagnosed with Kawasaki disease and significant cardiac abnormalities.
- To assess the impact of abciximab on coronary artery aneurysms and ectasia in pediatric KD.
Main Methods:
- Retrospective analysis of 15 pediatric KD patients treated with abciximab between 2007 and 2015.
- Data collection included clinical course, treatment details, echocardiographic findings, and 1- and 6-month follow-ups.
Main Results:
- Abciximab was administered to 15 children with KD, with a median disease onset of 10 days and abciximab administration on day 17.
- Eighty percent (12/15) of children showed resolution of coronary abnormalities by 6-month follow-up; 13.3% (2/15) had significant aneurysm regression.
- One patient with G6PD deficiency died due to inability to take aspirin.
Conclusions:
- Abciximab may play a role in managing severe cardiac complications associated with Kawasaki disease in children.
- Further prospective randomized controlled trials are necessary to definitively establish the role of abciximab in pediatric KD management.
Introduction:
There are limited data regarding the possible benefits of abciximab in children with Kawasaki disease (KD), who developed serious cardiac abnormalities non-responsive to standard treatment.
Materials And Methods:
We retrospectively identified children with KD who were treated with abciximab from 2007 to 2015. Data regarding clinical course, treatment, echocardiographic data and follow-up at 1 and 6months were retrieved.
Results:
During the study period, fifteen children were identified who were diagnosed with KD and were given abciximab. The median age at onset of symptoms was 11months (range: 2months-6years). The median day of disease at admission was 10days (range: 4-26days) and the median day of administration of abciximab was 17days (range: 9-40). Twelve children were diagnosed with complete and three with incomplete KD. Aneurysms were found in 8 children: 2 had ectatic coronary arteries and 5 presented with both ectasia and aneurysms. At 1month follow-up, echocardiographic findings showed regression in the size of aneurysms in 11 children, resolution of the aneurysms or ectasia of coronary arteries in 3 children, while one child who could not take aspirin because of G6PD deficiency died. After 6months of follow-up, echocardiographic findings showed resolution of coronary abnormalities in 12 (80%) children, whereas 2 children (13.3%) presented with significant regression of aneurysms.
Conclusions:
Abciximab may have an important role in the management of severe cardiac complications of KD, although prospective randomized controlled studies are needed to fully evaluate its role.
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