[Steroid pulse therapy]

Intravenous methylprednisolone pulse (IVMP) is usually given because of its powerful and rapid immunosuppressive effect. In a randomized control trial for all patients with Kawasaki disease(KD), IVMP plus initial immune globulin(IVIG), compared with IVIG plus placebo, did not decrease the incidence of coronary artery lesions(CAL). It has been reported that suspected IVIG-resistant patients who received initial IVIG plus IVMP, compared with IVIG alone, had earlier defervescence and a significantly lower rate of CAL. For patients resistant to initial or additional IVIG, some studies showed that IVMP was effective for fast defervescence and prevention of CAL. As it stands, IVMP is indicated for initial therapy combined with IVIG for suspected IVIG-resistant patients or rescue therapy for IVIG-resistant patients.