Antioxidants may mitigate the deterioration of coronary arteritis in patients with Kawasaki disease unresponsive to high-dose intravenous gamma-globulin

Pediatr Cardiol. 2001 Sep-Oct;22(5):419-22. doi: 10.1007/s002460010268.

Abstract

During the early stages of Kawasaki disease, a marked increase in oxygen-free-radicals (OFRs), which are produced by activated polymorphonuclear cells, may induce coronary arteritis. Early use of high-dose intravenous gamma-globulin (IVIG) and aspirin effectively blocked this deteriorating course of coronary arteritis; however, late use of IVIG, even using a high-dose schedule, did not achieve the same efficacy. The causes and reactions to the scenario of IVIG refractoriness have rarely been mentioned in the literature. We present an 11-month-old male infant with Kawasaki disease and deteriorating coronary arteritis owing to late use of IVIG who showed dramatic responsiveness to the addition of alpha-tocopherol and ascorbic acid. We also discuss the possible mechanism.

Publication types

  • Case Reports

MeSH terms

  • Antioxidants / administration & dosage*
  • Ascorbic Acid / administration & dosage*
  • Coronary Angiography
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Echocardiography
  • Humans
  • Immunization, Passive*
  • Infant
  • Male
  • Mucocutaneous Lymph Node Syndrome / diagnosis
  • Mucocutaneous Lymph Node Syndrome / drug therapy*
  • Treatment Outcome
  • alpha-Tocopherol / administration & dosage*

Substances

  • Antioxidants
  • alpha-Tocopherol
  • Ascorbic Acid