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Clinical Outcomes of Low-Dose Methotrexate Therapy as a Second-Line Drug for Intravenous Immunoglobulin-Resistant Kawasaki Disease

 Hyejin Jang  ;  Kyu Yeun Kim  ;  Dong Soo Kim 
 Yonsei Medical Journal, Vol.59(1) : 113-118, 2018 
Journal Title
 Yonsei Medical Journal 
Issue Date
C-Reactive Protein/analysis ; Child ; Preschool Child ; Coronary Vessels/pathology ; Demography ; Drug Dose-Response Relationship ; Combination Drug Therapy ; Female ; Humans ; Intravenous/*therapeutic use Immunoglobulins ; Infant ; Male ; Methotrexate/administration & dosage/*therapeutic use ; Mucocutaneous Lymph Node Syndrome/blood/*drug therapy ; Retrospective Studies ; Steroids/therapeutic use ; Treatment Outcome
Kawasaki disease ; coronary artery lesion ; immunoglobulin-resistant Kawasaki disease ; methotrexate
PURPOSE: Intravenous immunoglobulin (IVIG) is the standard treatment for Kawasaki disease (KD). However, there is still no standard treatment for IVIG-resistant KD. This study aimed to evaluate the efficacy of low-dose methotrexate (MTX) as a treatment for IVIG-resistant KD. MATERIALS AND METHODS: We retrospectively analyzed 10-year data for patients with IVIG-resistant KD who were administered MTX at Severance Children's Hospital. RESULTS: The subjects included 75 patients with KD aged 5 months to 9.2 years who had been administered MTX. Their maximum body temperatures decreased significantly within 24 h of therapy. The patients' C-reactive protein levels were significantly lower 1 week after administering the first dose of MTX than those before treatment. No adverse effect for MTX was observed. CONCLUSION: MTX treatment of IVIG-resistant KD resulted in rapid defervescence, improvement of clinical symptoms, and normalization of acute-phase reactants in all patients. Thus, MTX could be a candidate treatment for IVIG-resistant KD.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Soo(김동수)
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