Intravenous immunoglobulin-resistant Kawasaki disease treated with pulsed doses of methylprednisolone

Abstract EN

Kawasaki Disease (KD) is usually treated with high doses of Intravenous Immunogobulin (IVIG) and aspirin.

However, 10-15% of children with KD are resistant to IVIG therapy.

Corticosteroid therapy remains a controversial alternative in such cases.

We report a case of a four year old boy with KD who was resistant to treatment with high dose IVIG (2 courses of 2g / Kg/day) and aspirin (80mg / Kg / day) and was subsequently treated with pulsed doses of Methylprednisolone (30mg / Kg / day) for three days.

The child apparently responded with rapid defervescence, improvement in clinical symptoms, normalization of acute-phase reactants and no progression of coronary artery dilatation or any adverse effects.

Pulsed doses of Methyl prednisolone therapy appeared to be a safe and effective treatment for this particular IVIG–resistant KD patient.-