Strengthening the case for primary adjunctive corticosteroids for Kawasaki disease

Answers regarding the precise aetiology and optimal treatments for Kawasaki disease (KD) remain frustratingly elusive. The medium vessel vasculitis with a predilection for coronary arteries continues to be the leading cause of acquired heart disease in developed countries and is being increasingly recognised in less resourced areas. While the cause remains unclear, epidemiological data suggest an infectious trigger for genetically susceptible individuals. Contemporary treatments have drastically improved outcomes, although a select group of patients continue to experience morbidity beyond the inflammatory phase of the condition.

Robust evidence supports the use of intravenous immunoglobulin (IVIG) and aspirin for reducing the risk of KD-related coronary artery aneurysms (CAA). The role of other adjunctive therapies, however, remains unclear despite over 40 years of observational and interventional studies exploring a range of treatment options. The use of primary corticosteroid treatment has been particularly controversial, although there has been a growing enthusiasm for this...

from Archives of Disease in Childhood current issue https://ift.tt/3k2aEEY