Abstract
The primary aim of therapy of Kawasaki disease (KD) is to halt inflammation and prevent development of coronary artery aneurysms (CAAs). In this review, we provide an update on recent advances and current recommendations on management of KD. High-dose aspirin has not been found to have significant effect on development of CAAs in KD. Role of corticosteroids has been suggested in patients with high-risk disease and a recent Cochrane review has recommended addition of oral corticosteroids to all children with KD. Intensified initial therapy in the form of IVIg plus infliximab may be considered for patients with KD and CAAs. Recent literature has also suggested the role of infliximab, ant-IL-1 antagonist (anakinra), and cyclosporine in IVIg-resistant KD. Patients with giant CAAs or multiple complex medium-sized aneurysms in a single coronary artery need anticoagulation and aspirin. Intravenous immunoglobulin (2 g/kg) is the standard of care in all patients with KD. However, a proportion of patients may need additional therapy with corticosteroids or infliximab. Infliximab is also the drug of choice for IVIg-resistant KD.
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