Ruxolitinib combined with corticosteroids for the successful treatment of kawasaki disease-associated macrophage activation syndrome: a case report

Frontiers in Pediatrics · Published 2026-07-28 · DOI 10.3389/fped.2026.1845017

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Authors (6)

Xuan Wang, Jiaofeng Bai, Huihui Wang, Yanan Wang, Mayire Ainiwaner, Yaozhu Pan

Abstract

ObjectiveTo explore the diagnostic challenges of Kawasaki disease (KD)-associated macrophage activation syndrome (MAS) and the therapeutic value of ruxolitinib combined with corticosteroids.MethodsWe retrospectively analyzed the clinical data of one pediatric patient with KD-associated MAS and conducted sorting and analysis of relevant published literature.ResultsA 14-month-old male infant presented with fever and rash and was diagnosed with severe KD. Despite initial treatment with intravenous immunoglobulin (IVIG) and aspirin, he developed persistent fever, progressive cytopenia, hepatosplenomegaly, hypofibrinogenemia, hyperferritinemia, reduced NK-cell activity, and extremely elevated soluble interleukin-2 receptor (sCD25), fulfilling the HLH-2004 criteria for MAS. He was successfully treated with ruxolitinib plus methylprednisolone, with rapid resolution of fever, recovery of blood counts, and improvement in coagulation and inflammatory markers.ConclusionsKD-associated MAS is rare but life-threatening. Early recognition of warning signs and prompt initiation of ruxolitinib-based combination therapy can effectively control cytokine storm and improve clinical outcomes.

Abstract from DOAJ. Public domain (CC0 1.0).

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Publication details

Year
2026

Citation

Wang, X., Bai, J., Wang, H., et al. (2026). Ruxolitinib combined with corticosteroids for the successful treatment of kawasaki disease-associated macrophage activation syndrome: a case report. Frontiers in Pediatrics. https://doi.org/10.3389/fped.2026.1845017

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