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Yu JJ. Use of corticosteroids during acute phase of Kawasaki disease. World J Clin Pediatr. 2015;4(4):135-42doi: 10.5409/wjcp.v4.i4.135.
Yu, J. J. (2015). Use of corticosteroids during acute phase of Kawasaki disease. World journal of clinical pediatrics, 4(4), 135-42. https://doi.org/10.5409/wjcp.v4.i4.135
Yu, Jeong Jin. "Use of corticosteroids during acute phase of Kawasaki disease." World journal of clinical pediatrics vol. 4,4 (2015): 135-42. doi: https://doi.org/10.5409/wjcp.v4.i4.135
Yu JJ. Use of corticosteroids during acute phase of Kawasaki disease. World J Clin Pediatr. 2015 Nov 08;4(4):135-42. doi: 10.5409/wjcp.v4.i4.135. eCollection 2015 Nov 08. PMID: 26566486; PMCID: PMC4637804.
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World J Clin Pediatr. 2015 Nov 08;4(4):135-42. doi: 10.5409/wjcp.v4.i4.135. eCollection 2015 Nov 08.

Use of corticosteroids during acute phase of Kawasaki disease.

World journal of clinical pediatrics

Jeong Jin Yu

Affiliations

  1. Jeong Jin Yu, Department of Pediatrics Cardiology, College of Medicine, Ulsan University, Ulsan 680-749, South Korea.

PMID: 26566486 PMCID: PMC4637804 DOI: 10.5409/wjcp.v4.i4.135

Abstract

In spite of initial intravenous immunoglobulin (IVIG) treatment, a significant number of patients are unresponsive to it and are at a higher risk for coronary artery lesions. Corticosteroids have been used as a secondary drug or used in combination with IVIG. Three options of using corticosteroids for the treatment of patients during the acute phase of Kawasaki disease, have been considered. The first is their use exclusively for patients unresponsive to IVIG treatment. The second is their use in combination with IVIG as the routine first line therapy for all patients. The last is the use in the combination as the first line therapy for selected patients at a high risk being unresponsive to initial IVIG. However, it is uncertain that the corticosteroids as the second line treatment are better than the additional IVIG in patients unresponsive to initial IVIG. The combination of corticosteroids and IVIG as the routine first line therapy also have not enough evidences. The last option of using corticosteroids - the combination of corticosteroids and IVIG in patients at high risk of unresponsiveness, is a properly reasonable treatment strategy. However, there have been no globally standardized predictive models for the unresponsiveness to initial IVIG treatment. Therefore, future investigations to determine the best predictive model are necessary.

Keywords: Coronary aneurysm; Corticosteroids; Fever; Immunoglobulins; Kawasaki disease; Methylprednisolone; Prednisolone

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