Key result
Infliximab plus abciximab controls inflammation and markedly reduces coronary thrombus in IVIG-resistant Kawasaki disease.
Why the study?
Giant coronary artery aneurysms with thrombosis in Kawasaki disease can be fatal, and some patients show persistent inflammation despite standard treatments.
Case Report (n=1)
No
Infliximab may be a necessary rescue therapy for infants with resistant Kawasaki disease complicated by giant coronary aneurysms and thrombosis who fail standard treatments.
Supports infliximab-abciximab consideration in refractory infant Kawasaki with thrombosis; leaves open confirmation in prospective trials.
Giant coronary artery aneurysms that occur in 0.5 to 1% of patients with Kawasaki disease can be fatal if associated with thrombosis. Some patients may show persistent inflammation and fever despite treatment with repeated doses of intravenous immunoglobulin (IVIG), steroids, and aspirin. This report describes an infant boy with resistant Kawasaki disease who presented with extensive coronary artery involvement and coronary thrombosis. His inflammation was not controlled with multiple doses of IVIG, parenteral and oral steroids, or high-dose aspirin, and he finally needed infliximab, a monoclonal antibody against tumor necrosis factor alpha.
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Ayad Anass (2020) conducted a case report in Resistant Kawasaki Disease (n=1). Infliximab and Abciximab was evaluated. In a 13-month-old infant with IVIG-resistant Kawasaki disease, treatment with infliximab and abciximab successfully controlled inflammation and markedly reduced coronary thrombus size.
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