PMID- 23283289
OWN - NLM
STAT- MEDLINE
DCOM- 20130613
LR  - 20151119
IS  - 1531-698X (Electronic)
IS  - 1040-8703 (Linking)
VI  - 25
IP  - 1
DP  - 2013 Feb
TI  - Advances in the treatment of Kawasaki disease.
PG  - 103-9
LID - 10.1097/MOP.0b013e32835c1122 [doi]
AB  - PURPOSE OF REVIEW: Intravenous immunoglobulin (IVIG) and aspirin is the standard 
      initial therapy in the treatment of Kawasaki disease. Some patients have 
      persistent or recrudescent fever despite this therapy. Although there is no 
      conclusive body of evidence defining the best second and third-line therapies for 
      Kawasaki patients, there have been several recent studies published describing 
      the results of these therapies. RECENT FINDINGS: This review summarizes the 
      current recommendations for the initial therapy and describes the second and 
      third-line therapies studied in Japan and the United States. A recent study in a 
      Japanese population of Kawasaki disease patients at high risk for IVIG resistance 
      found that the group receiving steroids, in addition to IVIG and aspirin, had 
      fewer coronary artery abnormalities than the group receiving IVIG and aspirin 
      alone. Small studies of etanercept and infliximab have showed these TNF-alpha 
      blockers to be well tolerated and effective in the resolution of fever. SUMMARY: 
      Although most practitioners in the USA use IVIG as a second-line therapy for 
      those Kawasaki disease patients who have persistent or recrudescent fever, 
      promising new therapies are under study. Infliximab and steroids are currently 
      the two agents that have been most studied. However, larger studies and studies 
      in genetically diverse populations are needed.
FAU - Dominguez, Samuel R
AU  - Dominguez SR
AD  - Department of Pediatrics, Section of Infectious Diseases, Children's Hospital 
      Colorado, University of Colorado School of Medicine, Aurora, Colorado 80045, USA. 
      Samuel.dominguez@ucdenver.edu
FAU - Anderson, Marsha S
AU  - Anderson MS
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Pediatr
JT  - Current opinion in pediatrics
JID - 9000850
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - B72HH48FLU (Infliximab)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Aspirin/therapeutic use
MH  - Child
MH  - Drug Therapy, Combination
MH  - Glucocorticoids/therapeutic use
MH  - Humans
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Infliximab
MH  - Mucocutaneous Lymph Node Syndrome/*drug therapy
MH  - Treatment Failure
EDAT- 2013/01/04 06:00
MHDA- 2013/06/14 06:00
CRDT- 2013/01/04 06:00
PHST- 2013/01/04 06:00 [entrez]
PHST- 2013/01/04 06:00 [pubmed]
PHST- 2013/06/14 06:00 [medline]
AID - 10.1097/MOP.0b013e32835c1122 [doi]
PST - ppublish
SO  - Curr Opin Pediatr. 2013 Feb;25(1):103-9. doi: 10.1097/MOP.0b013e32835c1122.