Clinical Outcomes of Low-Dose Methotrexate Therapy as a Second-Line Drug for Intravenous Immunoglobulin-Resistant Kawasaki Disease
10.3349/ymj.2018.59.1.113
- Author:
Hyejin JANG
1
;
Kyu Yeun KIM
;
Dong Soo KIM
Author Information
1. Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea. dskim6634@yuhs.ac
- Publication Type:Original Article
- Keywords:
Kawasaki disease;
immunoglobulin-resistant Kawasaki disease;
methotrexate;
coronary artery lesion
- MeSH:
C-Reactive Protein/analysis;
Child;
Child, Preschool;
Coronary Vessels/pathology;
Demography;
Dose-Response Relationship, Drug;
Drug Therapy, Combination;
Female;
Humans;
Immunoglobulins, Intravenous/therapeutic use;
Infant;
Male;
Methotrexate/administration & dosage;
Methotrexate/therapeutic use;
Mucocutaneous Lymph Node Syndrome/blood;
Mucocutaneous Lymph Node Syndrome/drug therapy;
Retrospective Studies;
Steroids/therapeutic use;
Treatment Outcome
- From:Yonsei Medical Journal
2018;59(1):113-118
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
