{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:23:44Z","timestamp":1770747824328,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T00:00:00Z","timestamp":1666051200000},"content-version":"vor","delay-in-days":290,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The efficacy and safety of continuous intravenous infusion of cyclosporine A (CICsA) in patients with intravenous immunoglobulin\u2010resistant Kawasaki disease are unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2010 and 2020, 83 patients with Kawasaki disease that was not responsive to intravenous immunoglobulin (total dose \u2265\u20094\u2009g\/kg) were enrolled. All patients were started on CICsA (3\u2009mg\/kg\/day) and switched to oral cyclosporine A (CsA) (4\u20136\u2009mg\/kg\/day). Treatment efficacy, occurrence of coronary artery lesions (CALs), and laboratory parameters were evaluated. Patients were divided into two groups according to CICsA response: the responder group (afebrile \u226424\u2009h after CICsA without additional treatment) and the weak responder group (afebrile &gt;24\u2009h after CICsA requiring additional treatment).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010five patients became afebrile within 24 and 74\u2009h became afebrile in less than 72\u2009h. Adverse events included hypertension in four and hyperkalemia in two patients. Thirty\u2010nine patients were defined as responders and 44 patients as weak responders. There were no significant differences in CAL between the two groups. In weak responders, white blood cells, neutrophils, and C\u2010reactive protein levels were higher, and albumin, immunoglobulin G, and CsA concentration were lower than in responders, indicating that weak responders had more severe inflammatory findings. However, there were no significant differences in CAL. Logistic regression analysis revealed that the response to treatment for CICsA was associated with immunoglobulin G levels at baseline and CsA concentrations the day after CICsA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although CICsA required additional treatments in about half of the cases, a favorable clinical course was observed by using this strategy, especially for reducing CAL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.15280","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T23:54:58Z","timestamp":1666137298000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Continuous cyclosporine a infusion in patients with severe Kawasaki disease"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3293-9330","authenticated-orcid":false,"given":"Mitsuru","family":"Seki","sequence":"first","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaomi","family":"Minami","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadahiro","family":"Furui","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kensuke","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiko","family":"Yokomizo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4115-7640","authenticated-orcid":false,"given":"Daisuke","family":"Matsubara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Yamagata","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.12.073"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31815922b5"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.10.025"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2018.0030"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61930-2"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62298-9"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.028423"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-003-0264-3"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200106000-00022"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e318220c3cf"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32003-8"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.02.048"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.24953\/turkjped.2016.06.015"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200x.2005.02033.x"},{"key":"e_1_2_10_16_1","first-page":"109","article-title":"Continuous infusion of cyclosporin a in intravenous immunoglobulin resistant Kawasaki disease patients","volume":"34","author":"Minami T","year":"2011","journal-title":"Jichi Med. 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