Gram-negative Septicemia after Infliximab Treatment in an Infant with Refractory Kawasaki Disease
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Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Abstract
Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
참고문헌 (22)
- Melish ME, "Kawasaki syndrome", Pediatr Rev, 17, pp.153~162 (1996)
- Newburger JW, "The treatment of Kawasaki syndrome with intravenous gamma globulin", N Engl J Med, 315, pp.341~347 (1986)
- Burns JC, "Intravenous gamma-globulin treatment and retreatment in Kawasaki disease. US", Canadian Kawasaki Syndrome Study Group, 1998, pp.17, 1144~1148
- Sundel RP, "Gamma globulin re-treatmetn in Kawasaki disease", J Pediatr, 123, pp.657~659 (1993)
- Furukawa T, "Effects of steroid pulse therapy on immunoglobulin-resistant Kawasaki disease", Arch Dis Child, 93, pp.142~146 (2008)
- Burns JC, "Infliximab treatment for refractory Kawasaki syndrome", J Pediatr, 146, pp.662~667 (2005)
- Bongartz T, "Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies:systematic review and meta-analysis of rare harmful eff ects in randomized controlled trials", JAMA, 295, pp.2275~2285 (2006)
- 유호정, "Infliximab treatment for a patient withrefractory Kawasaki disease", Korean Journal of Pediatrics, 49(9), pp.987~990 (2006), 대한소아과학회
- Adriana H, "Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial", The Lancet, 83, pp.1731~1738 (2014)
- Shin JI, "Refractory Kawasaki disease: infliximab or methotrexate therapy?", Indian J Pediatr, 76, pp.1184~ (2009)
- Parashette KR, "Infliximab therapy in pediatric Crohn's disease: a review", Clin Exp Gastroenterol, 3, pp.57~63 (2010)
- Matsubara T, "Serum levels of tumor necrosis factor, interleukin 2 receptor, and interferon-gamma in Kawasaki disease involved coronaryartery lesions", Clin Immunol Immunopathol, 56, pp.29~36 (1990)
- Burns JC, "Infliximab treatment of intravenous immunoglobulin-resistant Kawasaki disease", J Pediatr, 153, pp.833~838 (2008)
- Mori M, "Efficacy and limitation of infliximab treatment for children with Kawasaki disease intractable to intravenous immunoglobulin therapy: report of an open-label case series", J Rheumatol, 39, pp.864~867 (2012)
- Maini RN, "Anti-cytokine therapy for rheumatoid arthritis", Annu Rev Med, 51, pp.207~229 (2000)
- Miyamoto H, "Fungal arthritis of the wrist caused by Candida parapsilosis during infliximab therapy for rheumatoid arthritis", Mod Rheumatol, 22, pp.903~906 (2012)
- Keane J, "Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent", N Engl J Med, 345, pp.1098~1104 (2001)
- Kroesen S, "Serious bacterial infections in patients with rheumatoid arthritis under anti-TNF-alpha therapy", Rheumatology, 42, pp.617~621 (2003)
- Stratakos G, "Cough and fever in a female with Crohn's disease receiving infliximab", Eur Respir J, 26, pp.354~357 (2005)
- Leung DY, "The potential role of bacterial superantigens in the pathogenesis of Kawasaki syndrome", J Clin Immunol, 15, pp.11S~17S (1995)
- Bergogne BE, "Acinetobacter spp. as nosocomial pathogens: Microbiological, clinical, and epidemiologic features", Clin Microbiol Rev, 9, pp.148~165 (1996)
- Bruns H, "Anti-TNF immunotherapy reduces CD8+ T cell-mediated antimicrobial activity against Mycobacterium tuberculosis in humans", J Clin Invest, 119, pp.1167~1177 (2009)