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The current treatment of choice for Kawasaki disease (KD) is intravenous immunoglobulin (IVIG) and high-dose aspirin. However, up to 20% of children are nonresponders (having persistent fever); these patients have higher risk for coronary artery damage and require additional therapy. In Japan, the Egami score (based on age, duration of illness, platelet count, and C-reactive protein) is a sensitive and specific tool used at diagnosis to determine IVIG treatment resistance (J Pediatr 2006; 149:237). These authors used the Egami tool to predict which children would have refractory disease and examined the clinical efficacy and safety of initial treatment with intravenous methylprednisolone-pulse plus IVIG combination therapy (IVMP+IVIG).
Parti…