Management of Kawasaki disease: Corticosteroids revisited

摘要

Kawasaki disease is an acute childhood vasculitis of unknown cause that causes coronary artery abnormalities in up to 20% of untreated children. First described in Japan in 1967/ the disease is now a leading cause of acquired heart disease in developed countries worldwide.2 High-dose intravenous immunoglobulin should be given within the first 10 days of illness to decrease the prevalence of coronary artery aneurysms from 20% to less than 5%-3 To reduce risk of coronary artery aneurysm further, investigators have pursued two therapeutic strategies. First, rescue treatments have been given to children with persistent or recrudescent fever after initial treatment with intravenous immunoglobulin;4"6 second, the patients at highest risk of aneurysms at diagnosis have been selected to receive intravenous immunoglobulin with adjunct anti-inflammatory treatment, such as corticosteroids, for more aggressive treatment.