Abstract
Acute Kawasaki disease (KD) is treated with high-dose intravenous immunoglobulin (IVIG), which is proven to decrease the incidence of coronary artery aneurysms from 25% to less than 5%. Aspirin is also given, although the evidence base is less secure. There is increasing evidence for steroid therapy as adjunctive primary therapy with IVIG, especially in Asian children. Approximately 10-30% of patients fail to respond to the initial IVIG and are at increased risk of coronary artery aneurysms. The optimal treatment for IVIG-nonresponsive KD remains controversial. Management options include further dose(s) of IVIG, corticosteroids, TNF-α blockade, cyclosporin A, anti-IL-1 and anti-CD20 therapy. In this article, the authors review the current evidence for treatment of acute KD and discuss options for IVIG nonresponders.
Original language | English |
---|---|
Pages (from-to) | 1203-1215 |
Number of pages | 13 |
Journal | Expert Review of Anti-Infective Therapy |
Volume | 10 |
Issue number | 10 |
DOIs | |
Publication status | Published - Oct 2012 |
Externally published | Yes |
Keywords
- anti-CD20
- anti-TNF-α
- aspirin
- IL-1
- IVIG
- Kawasaki disease
- nonresponder
- review
- treatment