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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2008.1
- 수록면
- 714 - 718 (5page)
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초록· 키워드
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Purpose: The aim of this study was to evaluate the efficacy of low-dose oral methotrexate (MTX) as a treatment for patients with Kawasaki disease (KD) which was resistant to intravenous immunoglobulin (IVIG). Patients and Methods: The patients who had persistent or recrudescent fever after treatment with IVIG were subsequently treated with low-dose oral MTX [10mg/body surface area (BSA)] once weekly. Results: Seventeen patients developed persistent or recrudescent fever after treatment of KD with IVIG and were consequently given MTX. The proportion of children with coronary artery lesions (CALs) was 76%. The median value of maximum body temperatures decreased significantly within 24 hours of MTX therapy (38.6℃ vs. 37.0℃, p<0.001). The median CRP (C- reactive protein) level was found to be significantly lower 1 week after administering the first dose of MTX (8.9mg/dL vs. 1.2mg/dL, p<0.001). The median duration of fever before MTX treatment was shorter in CALs (-) group than in CALs (+) group (7 days vs. 10 days, p=0.023). No adverse effects of MTX were observed. Conclusion: MTX treatment for IVIG-resistant KD resulted in quick resolution of fever and rapid improvement of inflammation markers without causing any adverse effects. MTX therapy should further be assessed in a multicenter, placebo-blinded trial to evaluate whether it also improves coronary artery outcome.
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참고문헌 (17)
참고문헌 신청
Ahn SY / 2005 / Treatment of intravenous immunoglobulin- resistant Kawasaki disease with methotrexate / Scand J Rheumatol 34 : 136 ~ 139
Burns JC / 1998 / Intravenous gamma-globulin treatment and retreatment in Kawasaki disease. US/Canadian Kawasaki Syndrome Study Group / Pediatr Infect Dis J 17 : 1144 ~ 1148
Figueiredo F / 1990 / Activation of the cAMP cascade inhibits an early event involved in murine macrophage Ia expression / J Biol Chem 265 : 12317 ~ 12323
Furukawa S / 1988 / Peripheral blood monocyte/macrophages and serum tumor necrosis factor in Kawasaki disease / Clin Immunol Immunopathol 48 : 247 ~ 251
Furusho K / 1984 / Kiyosawa N, Shinomiya K, Hayashidera T, et al. High-dose intravenous gammaglobulin for Kawasaki disease / Lancet 2 : 1055 ~ 1058
Burns JC / 1998 / Intravenous gamma-globulin treatment and retreatment in Kawasaki disease. US/Canadian Kawasaki Syndrome Study Group / Pediatr Infect Dis J 17 : 1144 ~ 1148
Figueiredo F / 1990 / Activation of the cAMP cascade inhibits an early event involved in murine macrophage Ia expression / J Biol Chem 265 : 12317 ~ 12323
Furukawa S / 1988 / Peripheral blood monocyte/macrophages and serum tumor necrosis factor in Kawasaki disease / Clin Immunol Immunopathol 48 : 247 ~ 251
Furusho K / 1984 / Kiyosawa N, Shinomiya K, Hayashidera T, et al. High-dose intravenous gammaglobulin for Kawasaki disease / Lancet 2 : 1055 ~ 1058
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