Management of acute and refractory Kawasaki disease

Carline E. Tacke, David Burgner, Irene M. Kuipers, Taco W. Kuijpers

Research output: Contribution to journalReview ArticleResearchpeer-review

15 Citations (Scopus)


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 languageEnglish
Pages (from-to)1203-1215
Number of pages13
JournalExpert Review of Anti-Infective Therapy
Issue number10
Publication statusPublished - Oct 2012
Externally publishedYes


  • anti-CD20
  • anti-TNF-α
  • aspirin
  • IL-1
  • IVIG
  • Kawasaki disease
  • nonresponder
  • review
  • treatment

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