Kawasaki disease resistant to immunoglobulin G therapy.

We describe a 3-year-old boy with Kawasaki disease who, despite therapy with two doses of intravenous immunoglobulin G and high-dose aspirin, developed myocarditis in the 1st week of illness and coronary artery aneurysms in the 2nd week. He required a short course of systemic corticosteroids for remission of the illness. The myocarditis subsided and coronary aneurysms remained static and uncomplicated during 6 weeks of follow-up. The diagnosis and recent trends in management of this not uncommon vasculitic disorder are outlined.