Abstract 145: Long Term Follow-up Of Children With Kawasaki Disease (KD) Treated With Infliximab (IFX) - Our Experience At Chandigarh, North India

Abstract

Background: Tuberculosis (TB) is endemic in India. Flare-up of TB is a concern in children treated with IFX. Objective: To report long-term follow-up of children with KD treated with IFX. Patients and methods: Study design: Review of records of 17 children with KD who had received IFX. Median age was 1.5 years (range 2 months to 6 years) Study setting: Pediatric Rheumatology Clinic, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, North India. Study duration: January 2007 to July 2014. Patient group: Patients with diagnosis of KD and given IFX were included and analyzed. 15 of these patients had received intravenous immunoglobulin (2g/kg) as first line therapy. Dose of IFX was 5-7 mg/kg given intravenously. Screening tests for TB (chest X-ray, tuberculin test) were not carried out prior to IFX infusion. Duration of follow-up:6 -12 months in 6 patients;13-30 months in 5 patients;45-65 months in 5 patients and 80 months in 1 patient (mean follow-up 30.6 ± 24.4 months). Results: None of the patients had any significant adverse reactions during infusion of IFX. On follow-up none of these patients has developed TB or any other significant infection. Twelve (12)/17 patients showed coronary artery abnormalities (CAAs) (table). Post IFX, 66% (8 of 12) patients with KD showed improvement in CAAs on follow-up. Conclusion: In our experience use of IFX was not associated with flare-up of any significant bacterial infection (including TB) during follow-up. 8/12 patients with CAAs showed resolution.