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Update on the Management of Kawasaki Disease

Kevin G Friedman1, Pei-Ni Jone2

  • 1Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Pediatric Clinics of North America
|September 5, 2020
PubMed

Insights

Kawasaki disease (KD) treatment with IVIG reduces coronary artery aneurysm (CAA) risk. High-risk patients may need additional anti-inflammatory therapies for optimal management.

Area of Science:

  • Pediatric Cardiology
  • Rheumatology
  • Pharmacology

Background:

  • Kawasaki disease (KD) is a critical pediatric illness.
  • Intravenous immunoglobulin (IVIG) is the standard acute treatment for KD.
  • Early IVIG administration significantly lowers the risk of coronary artery aneurysms (CAAs).

Purpose of the Study:

  • To review the acute pharmacologic management of Kawasaki disease.
  • To explore adjunctive primary therapy options for KD.
  • To discuss treatment strategies for IVIG-resistant KD patients.

Main Methods:

  • Literature review of acute pharmacologic management in Kawasaki disease.
  • Analysis of adjunctive therapies for initial KD treatment.
  • Evaluation of treatment approaches for IVIG-resistant cases.

Main Results:

  • IVIG reduces CAA risk from 25% to <5% when given within 10 days of fever onset.
  • Certain patient groups (IVIG resistance, young infants, highly inflamed, coronary changes) remain at high risk for CAAs.
  • Adjunctive anti-inflammatory treatments may benefit high-risk KD patients.

Conclusions:

  • Optimal acute pharmacologic management for Kawasaki disease is still under investigation.
  • Adjunctive therapies alongside IVIG show promise for high-risk KD patients.
  • Further research is needed to define the best treatment protocols for all KD patients, especially those resistant to IVIG.

Keywords:
Coronary artery aneurysmsCorticosteroidsIntravenous immunoglobulinKawasaki disease

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