この治療は、子宮頸がんワクチンの副反応の治療と同じですね。東京で治療ができたら良いですね。
川崎病に血漿交換や血漿交換とステロイドパルスで治療した例。
Cytokine. 2015 Aug;74(2):339-42. doi: 10.1016/j.cyto.2015.02.014. Epub 2015 Mar 19.
Kawasaki disease refractory to standard treatments that responds to a combination of pulsed methylprednisolone and plasma exchange: Cytokine profiling and literature review.
- 1
- Division of Pediatrics, National Center for Global health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo, Japan. Electronic address: motohiro612@yahoo.co.jp.
- 2
- Division of Pediatrics, National Center for Global health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo, Japan; Advanced and Specialized Medicine, Juntendo University Graduate School of Medicine, Japan.
- 3
- Division of Pediatrics, National Center for Global health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo, Japan.
Abstract
We present a case of Kawasaki Disease (KD) that was refractory to plasma exchange (PE), but which finally responded to concurrent intravenous methylprednisolone pulse (IVMP) and PE treatment. To determine direct and indirect evidence for the efficacy of this combination therapy, we analyzed data of patients with refractory KD by review of the literature using medical databases and cytokine profiling. For literature searches, we used the Pubmed™ and Ichushi™ databases. Search terms used included "Kawasaki disease" and "plasma exchange" to extract articles that described KD cases treated with PE. For cytokine profiling, we measured interleukin (IL)-6, soluble tumor necrosis factor-α receptor (sTNF-αR) type 1 and type 2 before and after PE and PE with IVMP. Our search revealed 201 KD patients treated with PE, of which PE treatment was effective in 188 patients (93.5%), but not in 13 cases (6.5%). All 13 cases were treated successfully with additional treatment. Of the 13 cases, only six (2.5%) had recurrence during the PE treatment period. In our case, cytokine profiling showed PE treatment decreased IL6, while sTNF-αR type1 and type2 remained at high levels. PE and IVMP decreased IL-6 and sTNFα-R type 1 and type 2 levels.
CONCLUSION:
PE concurrent with additional anti-inflammatory treatment such as IVMP might be a very promising treatment option for PE refractory patients.
