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2018, Número 3

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Alerg Asma Inmunol Pediatr 2018; 27 (3)


Enfermedad de Kawasaki refractaria

Moribe QIC, Cabrera VMA, Lee Ng R, Yamazaki NMA

Idioma: Español
Referencias bibliográficas: 37
Paginas: 94-102
Archivo PDF: 210.16 Kb.


RESUMEN

La enfermedad de Kawasaki es la segunda vasculitis aguda más frecuente en la edad pediátrica, la GGIV es el tratamiento establecido para la enfermedad. A nivel mundial se establece que un 10-20% de los pacientes manejados con GGIV a dosis de 2 g/kg/dosis no responden al tratamiento, siendo este grupo de pacientes un reto terapéutico para los médicos tratantes, se describen diferentes medidas terapéuticas como son: segunda dosis de GGIV, corticoesteroides en dosis altas, algunos anticuerpos monoclonales como infliximab, anakinra, etanercept, tocilizumab, rituximab y otros como metotrexate y plasmaféresis. En la búsqueda de identificar los pacientes de alto riesgo para no responder al tratamiento, grupos de expertos han creado herramientas diagnósticas aplicables al momento del diagnóstico con el fin de modificar las medidas terapéuticas y disminuir el riesgo de resistencia al tratamiento con GGIV, como son las escalas de Kobayashi, Sano y Egami, entre otras.


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