Acute Kawasaki Disease Therapy

  • Audrey Dionne
  • Jane W. Newburger
  • Kevin G. FriedmanEmail author
Cardiology/CT Surgery (K Gist, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardiology/CT Surgery


Purpose of review

We review the acute management of patients with Kawasaki disease (KD), including adjunctive primary therapies and the treatment of patients with resistance to intravenous immunoglobulin (IVIG).

Recent findings

IVIG administered within 10 days of fever in patients with (KD decreases the risk of coronary artery complication from ~ 25% to < 5%. However, patients at high risk of IVIG resistance or those with coronary changes at diagnosis may benefit from additional primary anti-inflammatory therapies.


All patients with suspected KD should be treated with aspirin and IVIG (2 g/kg). Patients at high risk of treatment resistance and/or coronary complications may benefit from adjunctive treatments, including corticosteroids or infliximab. Patients with persistent fever after initial IVIG treatment are at high risk of coronary complications and usually are retreated with IVIG. Corticosteroids, infliximab, cyclosporine, anakinra, and cyclophosphamide have also been described in patients refractory to initial therapy, though optimal therapy in this high-risk group remains unknown.


Kawasaki disease Adjunctive treatment IVIG resistance Intravenous immunoglobulin Infliximab Corticosteroids 


Compliance with Ethical Standards

Conflict of Interest

Audrey Dionne declares that she has no conflict of interest. Jane W. Newburger declares that she has no conflict of interest. Kevin G. Friedman declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Audrey Dionne
    • 1
    • 2
  • Jane W. Newburger
    • 1
    • 2
  • Kevin G. Friedman
    • 1
    • 2
    Email author
  1. 1.Department of CardiologyBoston Children’s HospitalBostonUSA
  2. 2.Department of PediatricsHarvard Medical SchoolBostonUSA

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