کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6222397 1607478 2012 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Calcineurin Inhibitor Treatment of Intravenous Immunoglobulin-Resistant Kawasaki Disease
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
پیش نمایش صفحه اول مقاله
Calcineurin Inhibitor Treatment of Intravenous Immunoglobulin-Resistant Kawasaki Disease
چکیده انگلیسی

ObjectiveTo describe the clinical course and outcome of 10 patients with Kawasaki disease (KD) treated with a calcineurin inhibitor after failing to respond to multiple therapies.Study designDemographic and clinical data were prospectively collected using standardized case report forms. T-cell phenotypes were determined by flow cytometry, and KD risk alleles in ITPKC (rs28493229), CASP3 (rs72689236), and FCGR2A (rs1801274) were genotyped.ResultsIntravenous followed by oral therapy with cyclosporine (CSA) or oral tacrolimus was well tolerated and resulted in defervescence and resolution of inflammation in all 10 patients. There were no serious adverse events, and a standardized treatment protocol was developed based on our experiences with this patient population. Analysis of T-cell phenotype by flow cytometry in 2 subjects showed a decrease in circulating activated CD8+ and CD4+ T effector memory cells after treatment with CSA. However, suppression of regulatory T-cells was not seen, suggesting targeting of specific, proinflammatory T-cell compartments by CSA.ConclusionTreatment of refractory KD with a calcineurin inhibitor appears to be a safe and effective approach that achieves rapid control of inflammation associated with clinical improvement.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Pediatrics - Volume 161, Issue 3, September 2012, Pages 506-512.e1
نویسندگان
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