ArticlePaediatrics & child health2011
Steroid pulse therapy for Kawasaki disease unresponsive to additional immunoglobulin therapy.
Article in Paediatrics & child health, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Kawasaki Disease.Arthritis care & research · 2022Guideline
- 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Kawasaki Disease.Arthritis & rheumatology (Hoboken, N.J.) · 2022Guideline
- Comparison of second-line therapy in IVIg-refractory Kawasaki disease: a systematic review.Pediatric rheumatology online journal · 2019Pooled it
- Pooled it
- [Evidence-based guidelines for the diagnosis and treatment of Kawasaki disease in children in China (2023)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Article
- Kawasaki Disease: A Systematic Review and Meta-Analysis of Benefits and Harms of Common Treatments.ACR open rheumatology · 2021Article
- Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta-analysis.Experimental and therapeutic medicine · 2021Article
- Kawasaki disease: guidelines of Italian Society of Pediatrics, part II - treatment of resistant forms and cardiovascular complications, follow-up, lifestyle and prevention of cardiovascular risks.Italian journal of pediatrics · 2018Review
- A Combination Therapy for Kawasaki Disease with Severe Complications: a Case Report.Open medicine (Warsaw, Poland) · 2018Article
- Prediction of unresponsiveness to second intravenous immunoglobulin treatment in patients with Kawasaki disease refractory to initial treatment.Korean journal of pediatrics · 2016Article
- Corticosteroid Therapy Might be Associated with the Development of Coronary Aneurysm in Children with Kawasaki Disease.Chinese medical journal · 2016Article
- Use of corticosteroids during acute phase of Kawasaki disease.World journal of clinical pediatrics · 2015Review
- Development of coronary artery lesions in indolent Kawasaki disease following initial spontaneous defervescence: a retrospective cohort study.Pediatric rheumatology online journal · 2015Article
- Follow-up on pediatric patients with bronchiolitis obliterans treated with corticosteroid pulse therapy.Orphanet journal of rare diseases · 2014Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal management of Kawasaki disease (KD) unresponsive to intravenous immunoglobulin (IVIG) therapy remains unclear.
objectiveTo prospectively evaluate the efficacy and safety of intravenous methylprednisolone pulse (IVMP) therapy in KD cases unresponsive to additional IVIG.
methodsKD patients who initially received IVIG (2 g/kg/24 h) and acetylsalicylic acid within nine days after disease onset were studied. Patients who did not respond received additional IVIG (2 g/kg/24 h), and those who still did not respond were given IVMP (30 mg/kg/day) for three days, followed by oral prednisolone. The response to treatment, echocardiographic findings and adverse effects were evaluated.
resultsAmong 412 KD cases, 74 (18.0%) were treated with additional IVIG; 21 (28.4%) of the latter cases subsequently received IVMP followed by prednisolone. All cases became afebrile soon after IVMP infusion and did not have a high-grade fever during treatment with prednisolone for two to six weeks. Four weeks after disease onset, coronary artery lesions (CAL) were diagnosed according to the Japanese Ministry of Health and Welfare or the American Heart Association criteria in two of the 21 cases treated with IVMP plus prednisolone; among all 412 cases, three (0.7%) and eight (1.9%) had CAL according to each criteria, respectively. All CAL regressed completely one year after disease onset. Adverse effects of IVMP, such as hypothermia and sinus bradycardia, resolved spontaneously.
conclusionsIn KD patients unresponsive to additional IVIG, IVMP promptly induced defervescence, and subsequent oral prednisolone suppressed recurrence of fever. IVMP followed by prednisolone therapy may prevent CAL, without severe adverse effects.
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