Intensifying Treatment in Children with Kawasaki Disease at High Risk for Coronary Aneurysm

A serious complication of Kawasaki disease (KD) is the development of coronary artery aneurysm (CAA), which may lead to myocardial infarction and cardiac death. Intravenous immunoglobulin (IVIg) is the mainstay preventive therapy, though recently, the addition of corticosteroids or infliximab to IVIg in children at high risk for CAA has shown positive results.

In a retrospective, multicenter study, researchers examined whether adjunctive therapy with corticosteroids or infliximab prevents progression of CAA that is present at the time of diagnosis. The study included 121 patients with evidence of CAA (coronary artery z-score ≥2.5 but <10) at the time of KD diagnosis. Patients' median age at diagnosis was 2.8 years, and 22% were younger than …