Guías de Práctica Clínica en Pediatría

324

Terapia de segunda línea o rescate

Utilizada en pacientes que no responden a la terapia inicial. Existen varias alternativas: 3ª

dosis de gamaglobulina, uso de corticoides (metilprednisolona), inhibidores del factor de

necrosis tumoral (infliximab, etanercept). De no haber respuesta a terapia de 2ª línea se puede

usar ciclosporina A, plasmaféresis o ciclofosfamida.

BIBLIOGRAFÍA

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immunoglobulin plus prednisolone for prevention of coronary artery abnormalities in severe Kawasaki

disease (RAISE study): a randomised, open-label, blinded-endpoints trial. Lancet 2012; published

online March 8. DOI:10.1016/S0140-6736(11) 61930-2.

3. Muta H, Ishii M, YashiroM et al. Late intravenous immunoglobulin treatment in patients with Kawasaki

disease. Pediatrics 2012; 129: e291.

4. Seki M, Kobayashi Tohru, Kobayashi Tomio, Morikawa A et al. External validation of a risk score to

predict intravenous immunoglobulin resistance in patients with Kawasaki disease. Pediatr Infect Dis

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5. Kawasaki syndrome. In: Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed,

Pickering LK (Ed), American Academy of Pediatrics, Elk Grove Village, IL 2009; p. 413.