What is the treatment for Kawasaki disease?

From the Guidelines

The primary treatment for Kawasaki disease is intravenous immunoglobulin (IVIG) at a dose of 2 g/kg given as a single infusion over 10-12 hours, along with high-dose aspirin (80-100 mg/kg/day divided into four doses) during the acute phase. This treatment should be initiated within the first 10 days of illness, ideally within 7 days, to reduce the risk of coronary artery abnormalities 1. The use of IVIG has been shown to reduce the incidence of coronary artery aneurysms from 25% to approximately 4% 1.

Key Considerations

• The diagnosis of Kawasaki disease is based on the identification of principal clinical findings and the exclusion of other clinically similar entities with known causes 1.
• The long-term prognosis is determined by the initial and current level of coronary artery involvement 1.
• Certain subsets of patients are at risk for myocardial ischemia from coronary artery thrombosis and stenoses, and medical management of such patients hinges on judicious use of thromboprophylaxis and vigilance to identify evolving stenoses 1.

Treatment Approach

• IVIG at a dose of 2 g/kg given as a single infusion over 10-12 hours, along with high-dose aspirin (80-100 mg/kg/day divided into four doses) during the acute phase is the recommended treatment approach 1.
• After the fever resolves, aspirin is typically reduced to a low dose (3-5 mg/kg/day as a single dose) and continued for 6-8 weeks or longer if coronary artery abnormalities are present 1.
• For patients who remain febrile 36-48 hours after completing IVIG, a second dose of IVIG may be given 1.
• In refractory cases, additional treatments may include corticosteroids, infliximab, cyclosporine, or other immunomodulators 1.

Monitoring and Follow-up

• Regular cardiac follow-up with echocardiograms is essential to monitor for coronary artery complications 1.
• The use of Z scores for classifying coronary artery involvement can help guide long-term management 1.

From the Research

Treatment for Kawasaki Disease

The treatment for Kawasaki disease typically involves a combination of medications to reduce inflammation and prevent complications.

• Intravenous immunoglobulin (IVIG) is a standard treatment for Kawasaki disease, and it has been shown to be effective in reducing the risk of coronary artery abnormalities 2, 3, 4, 5.
• Aspirin is often used in conjunction with IVIG, but its role in preventing coronary artery abnormalities is still debated 4, 5.
• Corticosteroids, such as prednisolone, may be used in addition to IVIG to reduce the risk of coronary artery abnormalities, especially in patients with severe Kawasaki disease 2, 6.

Medication Dosages

• The typical dosage of IVIG is 2 g/kg, administered over 24 hours 2, 4.
• Aspirin dosages vary, but high-dose aspirin (80-100 mg/kg/day) is often used in the acute phase of the disease 4, 5.
• Corticosteroid dosages, such as prednisolone, may vary, but a common dosage is 2 mg/kg per day 2.

Treatment Outcomes

• The combination of IVIG and corticosteroids has been shown to be effective in reducing the risk of coronary artery abnormalities in patients with Kawasaki disease 2, 6.
• The use of high-dose aspirin in addition to IVIG may not provide significant benefits in preventing coronary artery abnormalities 4, 5.
• The treatment outcomes may vary depending on the severity of the disease and the patient's response to treatment 3, 6.