New perspectives in the drug treatment of Kawasaki disease.

Kawasaki disease (KD) has become the leading cause of acquired heart disease in developed countries. Conventional therapy for KD includes intravenous gammaglobulin (2 g/kg as a single dose over 12 hours) and aspirin (acetylsalicylic acid; high dose until the fourteenth day of illness then low dose). Therapy administered within the first 10 days of the onset of the illness has been shown to reduce arterial wall inflammation and thereby prevent the development of coronary artery aneurysm formation. The majority of patients with KD will respond to conventional therapy. However, the management of nonresponders and patients with complications (such as acute thrombosis and chronic coronary artery changes) remains controversial. In this review article, we address some of these controversies and also describe newer treatment modalities that have been used in the management of patients with KD, both in the acute and convalescent stages of the disease.