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Recent advances in the treatment of Kawasaki disease

Ken-Pen Weng1, Shan-F Ou, Chu-Chuan Lin

  • 1Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, and National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.

Journal of the Chinese Medical Association : JCMA
|November 22, 2011
PubMed

Insights

Kawasaki disease (KD) is a childhood vasculitis. Current treatments like IVIG and aspirin may not prevent coronary artery lesions (CALs) in all children, necessitating further research into optimal management strategies.

Area of Science:

  • Pediatric Rheumatology
  • Cardiovascular Research
  • Immunology

Background:

  • Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
  • Coronary artery lesions (CALs) are a significant complication, affecting 15-25% of untreated patients.
  • Intravenous immunoglobulin (IVIG) is standard therapy, but 8-38% of patients are unresponsive.

Purpose of the Study:

  • To review current therapeutic strategies for Kawasaki disease.
  • To evaluate the efficacy of existing treatments in preventing CALs.
  • To identify areas for future research in KD management.

Main Methods:

  • Literature review of Kawasaki disease treatment protocols.
  • Analysis of data on the effectiveness of IVIG and aspirin in preventing CALs.
  • Discussion of alternative and emerging therapies.

Main Results:

  • High-dose IVIG is the gold standard but has limitations in unresponsive patients.
  • Aspirin, in conjunction with IVIG, showed no evidence of efficacy in preventing CALs.
  • The role of steroids and other immunosuppressants like infliximab requires further investigation.

Conclusions:

  • Optimal management of KD, especially for IVIG-resistant cases, remains to be defined.
  • Early intervention to manage chronic inflammation is crucial due to early subclinical atherosclerosis.
  • Multicenter studies are needed to establish definitive treatment guidelines for Kawasaki disease.

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