Effect of corticosteroids in addition to intravenous gamma globulin therapy on serum cytokine levels in the acute phase of Kawasaki disease in children

Okada, Yasunori; Shinohara, Makoto; Kobayashi, T.; Inoue, Yoshinari; Tomomasa, Takeshi; Kobayashi, Toshimitsu; Morikawa, Akihiro

doi:10.1067/s0022-3476(03)00387-1

Cited by 116 publications

(81 citation statements)

References 24 publications

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“…[14][15][16][17][18][19] A meta-analysis of these studies concluded that the addition of corticosteroids to intravenous immunoglobulin resulted in fewer coronary artery abnormalities than with treatment with intravenous immunoglobulin alone (OR 0·3, 95% CI 0·18-0·5). 20 However, heterogeneity in patient selection and treatment protocols severely limits application to our patient population.…”

Section: Discussionmentioning

confidence: 99%

“…20 However, heterogeneity in patient selection and treatment protocols severely limits application to our patient population. Three studies assessed 3-5 days of intravenous methylprednisolone (2 mg/kg per day) followed by a 2-4 week oral taper, 14,16,19 whereas the remaining three studies used a single pulse of intravenous methylprednisolone (30 mg/kg per day). 15,17,18 Five studies excluded patients with coronary artery abnormalities at baseline, [14][15][16]18,19 and two studies used Japanese scoring systems to select patients likely to be …”

Section: Discussionmentioning

confidence: 99%

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Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial

et al. 2014

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SummaryBackground Kawasaki disease, the most common cause of acquired heart disease in developed countries, is a self-limited vasculitis that is treated with high doses of intravenous immunoglobulin. Resistance to intravenous immunoglobulin in Kawasaki disease increases the risk of coronary artery aneurysms. We assessed whether the addition of infl iximab to standard therapy (intravenous immunoglobulin and aspirin) in acute Kawasaki disease reduces the rate of treatment resistance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial

et al. 2014

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“…Children to whom corticosteroids and IVIG were administered, compared with those who received IVIG alone, had reduced levels of cytokines, including interleukin-2 (IL-2), IL-6, IL-8, and IL-10 within 24 hours of IVIG administration. 164 At present, the usefulness of steroids in the initial treatment of Kawasaki disease is not well established (evidence level C). A National Heart, Lung, and Blood Institutefunded, multicenter randomized, placebo-blind trial that is in progress will provide more information on the effectiveness of such treatment.…”

Section: Ivigmentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Circulation

1,573

817

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Background— Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in ∼15% to 25% of untreated children and may lead to ischemic heart disease or sudden death. Methods and Results— A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for ≥5 days and ≤4 classic criteria should undergo echocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-α antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata. Conclusions— Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients.

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“…Corticosteroids are the golden standard in the treatment of other forms of vasculitis. Nevertheless, their use in children with KD is limited (Shulman, 2003) even though they are found to suppress markers of inflammation and decrease total fever duration (Nonaka et al, 1995;Okada et al, 2003).…”

Section: Initial Treatmentmentioning

confidence: 99%

Kawasaki Disease in a Tertiary Pediatric Referral Center in Athens, Greece and Review of the Literature

Skevaki¹,

Charalampaki²,

Pinna³

et al. 2011

Advances in the Diagnosis and Treatment of Vasculitis

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Effect of corticosteroids in addition to intravenous gamma globulin therapy on serum cytokine levels in the acute phase of Kawasaki disease in children

Cited by 116 publications

References 24 publications

Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial

Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Kawasaki Disease in a Tertiary Pediatric Referral Center in Athens, Greece and Review of the Literature

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