Open Access
ARTICLE
Kawasaki disease: Medical therapies
Jane W. Newburger
Department of Cardiology, Boston
Children’s Hospital, Department of
Pediatrics, Harvard Medical School, Boston,
Massachusetts
* Corresponding Author: Jane W. Newburger, MD, MPH, Department of Cardiology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115. Email:
Congenital Heart Disease 2017, 12(5), 641-643. https://doi.org/10.1111/chd.12502
Abstract
Medical therapies in patients with Kawasaki disease (KD) are administered to reduce the prevalence of coronary aneurysms, reduce systemic inflammation, and prevent coronary thrombosis. All
patients with acute KD should be treated with intravenous immunoglobulin (IVIG) 2 g/kg, generally
administered over 10–12 hours. Aspirin has never been shown to prevent aneurysms, but is given
for its anti-inflammatory and antipyretic effects until the patient has been afebrile for 2 days,
then lowered to an antiplatelet dose. Adjunctive therapy with a longer course of corticosteroids,
together with IVIG and aspirin, may be considered for primary treatment in patients at high risk
for development of aneurysms. For patients who have persistent or recrudescent fever after IVIG
treatment without other explanation, adjunctive therapies include retreatment with IVIG, a tapering course of corticosteroids, infliximab, cyclosporine, cyclophosphamide, and other
immunomodulatory therapies. Antithrombotic therapies are tailored to the risk of thrombosis, and
range from aspirin alone for 4–6 weeks in children without aneurysms to a combination of anticoagulation and antiplatelet therapy for those with giant aneurysms.
Keywords
Cite This Article
Newburger, J. W. (2017). Kawasaki disease: Medical therapies.
Congenital Heart Disease, 12(5), 641–643. https://doi.org/10.1111/chd.12502