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Kawasaki disease: 40 years after the original report

Abraham Gedalia1

  • 1Department of Pediatrics/Rheumatology, Children's Hospital, New Orleans, LA 70118, USA. a61543@pol.net

Current Rheumatology Reports
|August 11, 2007
PubMed

Insights

Kawasaki disease (KD) cause is unknown, but infections are suspected. While aspirin and IVIG improve outcomes, some patients resist treatment, necessitating further research into alternative therapies for this rare childhood illness.

Area of Science:

  • Pediatrics
  • Immunology
  • Infectious Diseases

Background:

  • Kawasaki disease (KD) etiology remains elusive, with infectious triggers suspected.
  • Current management includes aspirin and intravenous immunoglobulin (IVIG), significantly reducing coronary artery aneurysms and mortality.
  • Refractory cases pose a challenge, prompting investigation into alternative treatments.

Purpose of the Study:

  • To review the current understanding of Kawasaki disease etiology and management.
  • To explore treatment options for IVIG-resistant KD.
  • To discuss the potential role of novel anti-inflammatory and immunosuppressive agents.

Main Methods:

  • Literature review of epidemiologic and clinical observations.
  • Analysis of treatment outcomes for Kawasaki disease.
  • Evaluation of evidence for alternative therapies in refractory KD.

Main Results:

  • Aspirin and IVIG are effective primary treatments for KD.
  • Some evidence suggests IV pulse steroid therapy or infliximab may benefit IVIG-resistant patients.
  • A recent trial did not support adding pulsed methylprednisolone to primary IVIG therapy.

Conclusions:

  • While standard treatments improve KD outcomes, management of non-responders requires further investigation.
  • The role of steroids and biologics in refractory KD needs continued evaluation.
  • Future research may focus on immunosuppressive therapies and novel biologics for Kawasaki disease.

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