托珠单抗治疗 IVIG 无应答川崎病 2 例及文献回顾
摘要
的临床效果。方法 回顾性分析广西壮族自治区妇幼保健院住院的 2 例 IVIG 无应答川崎病患儿的症状、体征、辅助检查结
果及治疗经过，结合文献复习进行总结。结果 2 例患儿均使用 2 次 IVIG(2g/kg)，1 例体温正常 1 天后再次出现发热，1 例
仍持续发热。2 例病例均加用甲强龙，然而体温仍未正常。在使用首剂托珠单抗后，2 例病例体温很快降至正常，并且未再
反复，全身症状得到改善，复查炎症指标逐渐下降。结论 对常规 IVIG ＋糖皮质激素治疗仍无反应的川崎病患儿，托珠单
抗可成为一种新的替代治疗方案，疗效显著且用药安全。
关键词
全文:
PDF参考
[1] 中华医学会儿科学分会心血管学组 , 中华儿科杂志
编辑委员会 . 川崎病冠状动脉病变的临床处理建议 (2020 年
修订版 )[J]. 中华儿科杂志 ,2020,58(9):718-724.
[2]Center for Diagnosis and Treatment of Kawasaki Disease/
Children’sHospital of Shaanxi Provincial People’s Hospital et
al.Evidence-basedguidelines for the diagnosis and treatment of
Kawasaki disease in childrenin China (2023) [J].Zhongguo Dang
Dai Er Ke Za Zhi( 中国当代儿科杂志 ),2023, 25(12): 1198-210.
[3]Ahmed N,Pal P,Azad S M,et al.Risk factors in IG_xfffe_resistantKawasaki disease and correlation with Japanese
scoring systems - a studyfrom Eastern India[J].Clin
Rheumatol,2023,42(1):145-150.
[4] WU S,LIAO Y,SUN Y,et al.Prediction of intravenous
immunoglobulin resistance in Kawasaki disease in
children[J].World J Pediar,2020,16(6):607-613.
[5]Mahajan A, Yadav S, Maheshwari A, et al. Profile of
children with Kawasaki disease associated with tropical infections.
Indian J Pediatr.2022;89(8):759–764.doi:10.1007/s12098-021-
03953-9
[6]Olivito B, Taddio A, Simonini G, et al. Defective FOXP3
expression in patients with acute Kawasaki disease and restoration
by intravenous immunoglobulin therapy. Clin Exp Rheumatol.
2010;28(1Suppl 57):93–97.
[7]Ni FF, Li CR, Li Q, et al. Regulatory T cell microRNA
expression changes in children with acute Kawasaki disease. Clin
Exp Immunol. 2014;178 (2):384–393.doi:10.1111/cei.12418
[8]Nozawa T, Imagawa T, Ito S. Coronary- Artery Aneurysm
in Tocilizumab- Treated Children with Kawasaki’s Disease[J]. N
Engl J Med. 2017 Nov 9;377(19):1894- 1896.
[9]Schett G. Physiological effects of modulating the
interleukin-6 axis. Rheumatology.2018;57(suppl_2):ii43–ii50.
doi:10.1093/rheumatology/kex513
[10]Huang XB, Zhao S, Liu ZY, Xu YY, Deng F. Serum
amyloid A as a biomarker for immunoglobulin resistance in
Kawasaki disease.Ann Med.2023;55(2):2264315.doi:10.1080/078
53890.2023.2264315
[11] Wu Y, Liu FF, Xu Y, et al. Interleukin-6 is prone to
be a candidate biomarker for predicting incomplete and IVIG
nonresponsive Kawasaki disease rather than coronary artery
aneurysm.Clin Exp Med.2019;19(2):173–181.doi:10.1007/
s10238-018-00544-5
[12]Ikeda K, Mizoro Y, Ameku T, et al. Transcriptional
analysis of intravenous immunoglobulin resistance in Kawasaki
disease using an induced pluripotent stem cell disease model. Circ
J. 2016;81(1):110–118. doi:10.1253/circj.CJ-16-0541
[13]Si F, Wu Y, Gao F, et al. Relationship between IL-27
and coronary arterial lesions in children with Kawasaki disease.
Clin Exp Med.2017;17(4):451–457.doi:10.1007/s10238-017-
0451-8
[14]Okitsu-Negishi S, Nakano I, Suzuki K, et al. The
induction of cardioangitis by Lactobacillus casei cell wall in
mice. I. The cytokine production from murine macrophages by
Lactobacillus casei cell wall extract. Clin Immunol Immunopathol.
1996;78(1):30–40. doi:10.1006/clin.1996.0005
[15]Abrams JY, Weintraub ES, Baggs JM, et al. Childhood
vaccines and Kawasaki disease, vaccine safety datalink,
1996-2006.Vaccine.2015;33(2):382-387.doi:10.1016/
j.vaccine.2014.10.044
[16]Tanaka T,Narazaki M,Kishimoto T.IL-
6 inflammation,immu-nity,and disease [J].Cold Spring
HarbPerspectBiol,2014,6 (10):a016295
[17]Sebba A. Tocilizumab: The first interleukin-6-receptor
inhibitor[J].Am J Health Syst Pharm, 2008, 65(15): 1413-1418.
[18]Q L, LO L, Yuan W T, et al. FDA approval
summary:Tocilizumab for treatment of chimeric antigen recepter T
cell inducedsevereor life threatening cytokine release syndrome[J].
Oncologist,2018,23(8):943-947.
[19] 中 华 医 学 会 儿 科 学 分 会 心 血 管 学 组 , 中 华 医 学
会儿科学分会风湿学组 , 中 华医学会儿科学分会免疫学
组 , 等 . 川崎病诊断和急性期治疗专家共识 [J]. 中华儿科杂
志 ,2022,60(1):6- 13.
(6 摘要 Views, 13 PDF Downloads)
Refbacks
- 当前没有refback。