Kawasaki Disease: Evidence of Benefit with Corticosteroids

Kawasaki disease is an acute systemic vasculitis that presumably is infectious, although no infectious cause has been discovered. The major complication is the development of arterial aneurysms, especially in the coronary arteries. Although intravenous immunoglobulin (IVIG) has been shown to speed resolution of the acute disease and to prevent aneurysms in more than 90% of patients, a considerable number of patients still experiences morbidity. Corticosteroids, although not beneficial in early studies, showed potential benefit in a later retrospective review from Japan (see JWID Dec 1 1999). Researchers from Harvard Medical School conducted a prospective, unblinded, randomized trial comparing IVIG (2 g/kg) plus a pulse of intravenous methyl…