Use of Infliximab in the Treatment of Macrophage Activation Syndrome Complicating Kawasaki Disease

Abstract

Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology. KD can be complicated with macrophage activation syndrome. The optimal treatment for this KD complication has not been established, and a variety of treatments have been used. Infliximab, a chimeric monoclonal antibody that binds tumor necrosis factor, has proved to be efficacious in IV gammaglobulin resistant KD. We present 2 cases of KD complicated with macrophage activation syndrome, including 1 patient with DiGeorge syndrome successfully treated with a combined treatment of IV gammaglobulin, corticosteroids, cyclosporine, and infliximab.

Targeting TNF-α for COVID-19: Recent Advanced and Controversies

“…IFX, a recombinant humanized monoclonal antibody against TNF-α, is now approved for use in several immune-mediated disorders, including psoriasis, RA, IBD, ankylosing spondylitis, and IVIG resistant KD (74)(75)(76)(77). Numerous studies have reported that combined treatment with IFX was related to clinical and biochemical improvement in KD complicated with MAS (78). Considering the potential similar pathophysiology between KD complicated with MAS and MIS-C, which is also potentially related to CRS to a certain extent, IFX may play a vital role in CRS with COVID-19.…”