[Refractory Kawasaki disease with coronary aneurysms treated with infliximab]

Abstract

The classic treatment of Kawasaki disease with immunoglobulin and acetyl salicylic acid obtains a good response in 90% of patients, decreasing the risk of coronary involvement. However, in patients that do not respond to immunoglobulin, it is not clear which therapy should be used: other doses of immunoglobulin, corticosteroids or infliximab. Infliximab is becoming an important second line treatment for Kawasaki refractory to immunoglobulin, although there are few studies and clinical reports with this drug. We present a 5 months-old infant with refractory Kawasaki disease who developed coronary aneurysms despite two immunoglobulin doses and three intravenous pulses-doses of corticosteroids. The infant was finally treated with a single dose of infliximab with good clinical progress.