Immunoglobulin-resistant kawasaki disease associated with human parvovirus B19 infection

A 23-month-old female presented with 6 full symptoms of Kawasaki disease (KD) and thrombocytopenic purpura of the lower extremities. Repeated intravenous immunoglobulin normalized the platelet counts, but not improved the activity of intractable KD. Primary infection of human parvovirus B19 (B19V) was determined at the diagnosis of KD based on the hypocomplementemia and the positive tests for anti-B19V IgM antibody. Infliximab therapy led to the complete resolution with no atypical or persistent infection of B19V, or coronary artery lesions. This is the first report of intravenous immunoglobulin-resistant KD associated with the primary infection of B19V. Successful treatment of the B19V-associated KD case suggested a clinical utility of the standard rescue infliximab for the treatment of intravenous immunoglobulin-resistant KD, possibly with concurrent infection. Abbreviations: B19V: human parvovirus B19, IVIG: ntravenous immunoglobulin, KD: Kawasaki disease

infliximab

Kawasaki disease

parvovirus B19

virus reactivation