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

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