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Treatment of intravenous immunoglobulin-resistant Kawasaki disease with methotrexate

Authors
 S-Y Ahn  ;  DS Kim 
Citation
 SCANDINAVIAN JOURNAL OF RHEUMATOLOGY, Vol.34(2) : 136-139, 2005 
Journal Title
 SCANDINAVIAN JOURNAL OF RHEUMATOLOGY 
ISSN
 0300-9742 
Issue Date
2005
MeSH
Child ; Child, Preschool ; Dexamethasone/therapeutic use ; Dose-Response Relationship, Drug ; Drug Resistance/drug effects* ; Drug Therapy, Combination ; Female ; Fever/drug therapy ; Humans ; Immunoglobulins, Intravenous/therapeutic use* ; Immunosuppressive Agents/therapeutic use* ; Infant ; Male ; Methotrexate/therapeutic use* ; Mucocutaneous Lymph Node Syndrome/drug therapy* ; Mucocutaneous Lymph Node Syndrome/physiopathology ; Treatment Outcome
Keywords
16095010
Abstract
OBJECTIVE: To evaluate the effect of low-dose oral methotrexate (MTX) as treatment for patients with Kawasaki disease (KD) resistant to intravenous immunoglobulin (IVIG). METHODS: The subjects were four patients with KD, aged 8 months to 8 years old, who showed persistent disease after treatment with high-dose IVIG (2 g/kg) and aspirin (100 mg/kg). These patients were re-treated with IVIG and were also treated with IV dexamethasone (0.3 mg/kg). IV dexamethasone induced defervescence in three patients, but fever recurred upon discontinuing the steroid. One patient showed no response to either IVIG or dexamethasone. All patients were subsequently treated weekly with low-dose oral MTX [10 mg/body surface area (BSA)]. RESULTS: MTX treatment resulted in rapid defervescence, improvement in clinical symptoms, and normalization of acute-phase reactants in all patients. There was no progression of coronary artery dilatation and MTX was discontinued with no recurrence of fever. No adverse effects of MTX were observed. CONCLUSION: Low-dose oral MTX is an effective treatment for refractory KD.
Full Text
http://web.a.ebscohost.com/ehost/detail?sid=0de1c701-fe95-4b82-9db6-78895fe26a76%40sessionmgr4002&vid=1&hid=4107&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=mnh&AN=16095010
DOI
OAK-2005-04337
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Soo(김동수)
Ahn, Sun Young(안선영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151004
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