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Boletín médico del Hospital Infantil de México
Print version ISSN 1665-1146
Abstract
MARRIAGA-NUNEZ, Bibiana et al. Immunoglobulin-resistant Kawasaki disease. Bol. Med. Hosp. Infant. Mex. [online]. 2023, vol.80, n.4, pp.260-264. Epub Oct 09, 2023. ISSN 1665-1146. https://doi.org/10.24875/bmhim.23000078.
Background:
Kawasaki disease is a systemic vasculitis that affects small and medium-sized vessels, primarily the coronary arteries. First-line treatment includes intravenous immunoglobulin (IVIG) and acetylsalicylic acid; however, 20% do not respond adequately despite treatment. We describe a case treated with etanercept after initial IVIG failure, showing a good response.
Case report:
A 5-year-old female was diagnosed with classic Kawasaki disease. Echocardiography and angiotomography revealed giant and fusiform aneurysms in the coronary arteries. A first dose of IVIG therapy was administered without improvement; after the second dose, the fever persisted, so etanercept was administered, and the fever subsided. There were no new lesions in medium-caliber vessels and the previously identified coronary lesions did not progress.
Conclusions:
The use of etanercept in Kawasaki disease has demonstrated a clinically favorable response. Controlled clinical trials of this drug are needed to establish it as a formal therapy in cases of initial IVIG failure.
Keywords : Kawasaki disease; Therapeutic failure; TNFα; Etanercept; Case report.