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首页> 外文期刊>Cytokine >Kawasaki disease refractory to standard treatments that responds to a combination of pulsed methylprednisolone and plasma exchange: Cytokine profiling and literature review
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Kawasaki disease refractory to standard treatments that responds to a combination of pulsed methylprednisolone and plasma exchange: Cytokine profiling and literature review

机译：对脉冲甲基强的松龙和血浆置换相结合的标准疗法难治的川崎病：细胞因子分析和文献综述

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摘要

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 (TM) and Ichushi (TM) 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-alpha receptor (sTNF-alpha R) 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-alpha R type1 and type2 remained at high levels. PE and IVMP decreased IL-6 and sTNF alpha-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. (C) 2015 Elsevier Ltd. All rights reserved.
机译：我们介绍了一例川崎病（KD），难治性血浆置换（PE），但最终对并发的甲基强的松龙脉搏（IVMP）和PE治疗产生了反应。为了确定这种联合疗法疗效的直接和间接证据，我们通过使用医学数据库和细胞因子分析对文献进行回顾，分析了难治性KD患者的数据。对于文献搜索，我们使用了Pubmed（TM）和Ichushi（TM）数据库。使用的搜索词包括“川崎病”和“血浆置换”，以提取描述用PE治疗的KD病例的文章。对于细胞因子分析，我们测量了PE和PE合并IVMP前后的白介素（IL）-6，可溶性肿瘤坏死因子-α受体（sTNF-alpha R）1型和2型。我们的搜索显示201例接受KD的PE患者，其中188例（93.5％）有效，但13例（6.5％）无效。全部13例均获得成功，并接受了额外的治疗。在13例中，PE治疗期间仅6例（2.5％）复发。在我们的案例中，细胞因子分析显示PE治疗可降低IL6，而sTNF-alpha R type1和type2仍保持高水平。 PE和IVMP降低了IL-6和sTNF alpha-R 1型和2型水平。结论：PE并辅以IVMP等抗炎治疗可能是PE难治性患者非常有前途的治疗选择。 （C）2015 Elsevier Ltd.保留所有权利。

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