From the Guidelines
Kawasaki disease treatment typically involves the administration of intravenous immunoglobulin (IVIG) at a dose of 2 grams per kilogram, in conjunction with high-dose aspirin at 80-100 mg/kg/day, divided into four doses 1.
Key Treatment Components
- IVIG: 2 grams per kilogram, administered as a single infusion 1
- High-dose aspirin: 80-100 mg/kg/day, divided into four doses, for its anti-inflammatory effect 1
Treatment Duration and Follow-up
- Therapy should be initiated within 10 days of fever onset if possible 1
- Aspirin is continued at a lower dose of 3-5 mg/kg/day for a total duration of 6-8 weeks, or until inflammation has resolved
- For patients who do not respond to initial IVIG treatment, a second dose of 2 grams per kilogram may be administered 1
Additional Considerations
- Corticosteroids, such as prednisolone, may also be considered as adjunctive therapy in cases of IVIG-resistant disease
- Measles and varicella immunizations should be deferred for 11 months after a child receives high-dose IVIG 1
From the Research
Treatment Overview
The treatment for Kawasaki disease typically involves a combination of medications to reduce inflammation, prevent coronary artery aneurysms, and manage symptoms.
- Intravenous immunoglobulin (IVIG) is a key component of treatment, with a recommended dose of 2 g/kg administered over 10-12 hours 2, 3.
- Aspirin is also commonly used for its anti-inflammatory and antipyretic effects, although its role in preventing aneurysms is less clear 2, 3.
Adjunctive Therapies
For patients who do not respond to initial IVIG treatment, adjunctive therapies may be considered, including:
- Retreatment with IVIG 2, 3, 4
- Corticosteroids, such as prednisolone 3, 4
- Infliximab, a TNF-α blocker 5
- Other immunomodulatory therapies, such as cyclosporine and cyclophosphamide 2
Treatment of Resistant Kawasaki Disease
For patients with resistant Kawasaki disease, infliximab has been shown to be a safe and effective treatment option, resulting in shorter duration of fever, reduced need for additional therapy, and shorter hospitalization compared to second IVIG infusion 5.
- A study comparing infliximab to second IVIG infusion found that infliximab was associated with a higher rate of fever resolution and fewer adverse events 5.
Coronary Artery Aneurysm Prevention
The goal of treatment is to prevent coronary artery aneurysms, which can be a serious complication of Kawasaki disease.