Steroids in Primary Therapy for Kawasaki Disease

A multicenter study conducted in Japan showed short-term improvement in inflammation, but long-term cardiac results remain unclear.

Steroids as an adjunct to intravenous immune globulin (IVIG) and aspirin have been investigated for treatment of Kawasaki disease (KD) and prevention of KD-associated coronary-artery abnormalities (CAAs). Findings from a small study in the U.S. suggested earlier improvement in measures of inflammation when steroids were added to an IVIG regimen, but the study was underpowered to detect improvement in CAA outcomes (see Journal Watch Infectious Diseases Aug 25 2003). Now, researchers in Japan have conducted a larger study to examine the latter question.

One hundred seventy-eight KD patients were enrolled in this prospective, nonblinded multicenter study. The patients were randomized to IVIG (1 g/kg/day for 2 days) plus prednisolone (2 mg/kg/da…

Reviewing Author

Robert S. Baltimore, MD