PMID- 28390409
OWN - NLM
STAT- MEDLINE
DCOM- 20171226
LR  - 20181113
IS  - 1471-2431 (Electronic)
IS  - 1471-2431 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Apr 8
TI  - A child with resistant Kawasaki disease successfully treated with anakinra: a 
      case report.
PG  - 102
LID - 10.1186/s12887-017-0852-6 [doi]
LID - 102
AB  - BACKGROUND: Kawasaki disease (KD) is an acute self-limited systemic vasculitis of 
      unknown etiology. Intravenous immunoglobulin (IVIG) is an effective treatment and 
      decreases the risk of cardiac complications to less than 5%. In spite of its 
      effectiveness, some children do not respond to this therapy and still develop 
      coronary aneurysms (CAA). The optimal treatment for IVIG non-responsive patients 
      remains controversial although corticoids have been suggested to be an effective 
      treatment in some patients. For those patients still resistant to IVIG and 
      corticoids, interleukin-1 receptor antagonists (IL-1RA) such anakinra could be an 
      alternative. CASE PRESENTATION: We present a 3 year-old Caucasian patient with KD 
      without cardiac complications but with important resistance to treatment. After 
      becoming resistant to IVIG and corticoids, anakinra proved to be an effective 
      treatment. CONCLUSIONS: To our knowledge, this is the first report of the utility 
      of IL-1RA in refractory KD without coronary impairment. The patient fulfilled the 
      classical criteria for KD and, after becoming resistant to first and second line 
      treatments, anakinra proved to be an effective treatment. Further studies are 
      required to determine if this is an effective treatment option for other cases of 
      resistant Kawasaki disease.
FAU - Sanchez-Manubens, J
AU  - Sanchez-Manubens J
AD  - Pediatric Rheumatology Unit, Pediatrics Department, Hospital Parc Tauli Sabadell, 
      Barcelona, Spain. jsanchez@tauli.cat.
AD  - Pediatric Rheumatology Unit, Pediatrics Department, Hospital Sant Joan de Deu 
      Esplugues, Barcelona, Spain. jsanchez@tauli.cat.
FAU - Gelman, A
AU  - Gelman A
AD  - Pediatrics Department, Hospital Parc Tauli Sabadell, Barcelona, Spain.
FAU - Franch, N
AU  - Franch N
AD  - Pediatrics Department, Hospital Parc Tauli Sabadell, Barcelona, Spain.
FAU - Teodoro, S
AU  - Teodoro S
AD  - Pediatric Cardiology Unit, Pediatrics Department, Hospital Parc Tauli Sabadell, 
      Barcelona, Spain.
FAU - Palacios, J R
AU  - Palacios JR
AD  - Pediatric Cardiology Unit, Pediatrics Department, Hospital Parc Tauli Sabadell, 
      Barcelona, Spain.
FAU - Rudi, N
AU  - Rudi N
AD  - Pharmacy Department, Hospital Parc Tauli Sabadell, Barcelona, Spain.
FAU - Rivera, J
AU  - Rivera J
AD  - Pediatrics Department, Hospital Parc Tauli Sabadell, Barcelona, Spain.
FAU - Anton, J
AU  - Anton J
AD  - Pediatric Rheumatology Unit, Pediatrics Department, Hospital Sant Joan de Deu 
      Esplugues, Barcelona, Spain.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20170408
PL  - England
TA  - BMC Pediatr
JT  - BMC pediatrics
JID - 100967804
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Interleukin 1 Receptor Antagonist Protein)
SB  - IM
MH  - Anti-Inflammatory Agents/*therapeutic use
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Interleukin 1 Receptor Antagonist Protein/*therapeutic use
MH  - Mucocutaneous Lymph Node Syndrome/diagnosis/*drug therapy
PMC - PMC5385011
OTO - NOTNLM
OT  - Anakinra
OT  - Case report
OT  - IL1 blockade
OT  - IVIG resistance
OT  - Kawasaki disease
EDAT- 2017/04/10 06:00
MHDA- 2017/12/27 06:00
PMCR- 2017/04/08
CRDT- 2017/04/10 06:00
PHST- 2016/04/28 00:00 [received]
PHST- 2017/03/29 00:00 [accepted]
PHST- 2017/04/10 06:00 [entrez]
PHST- 2017/04/10 06:00 [pubmed]
PHST- 2017/12/27 06:00 [medline]
PHST- 2017/04/08 00:00 [pmc-release]
AID - 10.1186/s12887-017-0852-6 [pii]
AID - 852 [pii]
AID - 10.1186/s12887-017-0852-6 [doi]
PST - epublish
SO  - BMC Pediatr. 2017 Apr 8;17(1):102. doi: 10.1186/s12887-017-0852-6.