Kawasaki disease complicated by aspergillosis under cyclosporine and infliximab

[...]Inoue reported 4 a 5-year-old boy diagnosed with KD (Day 5). Because of IVIG resistance, he received repeated IVIG, intravenous methylprednisolone pulse (IVMP; Days 6–9), plasma exchange, and 5 mg/kg infliximab (Day 13). [...]Ishikawa 5 reported a 2-month-old girl diagnosed with KD (Day 5). Bec...

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Bibliographic Details
Published in:Pediatric investigation 2022-01, Vol.64 (1), p.e15300-n/a
Main Authors: Honda, Kana, Watanabe, Yoshitaka, Motegi, Sakura, Watanabe, Tsuneki, Ikeda, Hirokazu
Format: Article
Language:English
Subjects:
Antigens
Apheresis
Aspergillosis
Aspergillosis - complications
Blood tests
Coronary vessels
cyclosporine
Cyclosporine - therapeutic use
Cyclosporins
Drug dosages
Fever
Fungal infections
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Immunology
Immunosuppressive Agents - therapeutic use
Infliximab
Infliximab - therapeutic use
Kawasaki disease
Monoclonal antibodies
Mucocutaneous lymph node syndrome
Mucocutaneous Lymph Node Syndrome - complications
Mucocutaneous Lymph Node Syndrome - diagnosis
Mucocutaneous Lymph Node Syndrome - drug therapy
Pediatrics
refractory
Tumor necrosis factor-α
Ultrasonic imaging
Veins & arteries
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Summary:[...]Inoue reported 4 a 5-year-old boy diagnosed with KD (Day 5). Because of IVIG resistance, he received repeated IVIG, intravenous methylprednisolone pulse (IVMP; Days 6–9), plasma exchange, and 5 mg/kg infliximab (Day 13). [...]Ishikawa 5 reported a 2-month-old girl diagnosed with KD (Day 5). Because of IVIG resistance, she received repeated IVIG, IVMP (Days 8–9, 15–16), and plasma exchange. Table 1 Cases of Kawasaki disease complicated with aspergillosis References Age Sex Infliximab Cyclosporine IVMP Plasma exchange Antifungal medicine CAL Inoue 4 5 years Male (+) (−) (+) (+) Voriconazole (+) Ishikawa 5 2 months Female (−) (−) (+) (+) L-AMB (+) Our patient 14 months Female (+) (+) (−) (−) Micafungin (−) CAL, coronary artery lesions; IVIG, intravenous immunoglobulin; IVMP, intravenous methylprednisolone pulse; L-AMB, liposomal amphotericin B. As far as we are aware, this is the first report on aspergillosis after treatment with cyclosporine and infliximab for refractory KD. [...]in cases of recurrent fever and poor improvement of inflammation in blood tests after acute KD treatment with cyclosporine or infliximab, complications of aspergillosis should be considered.
ISSN:1328-8067
2096-3726
1442-200X
2574-2272
DOI:10.1111/ped.15300