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How is Kawasaki disease treated?

Kawasaki disease is a rare condition and affects boys more often than girls, and mostly children who are under age 5. In this poorly understood disease, the body’s immune system attacks the body’s own tissues. This results in inflammation of blood vessels (including those supplying blood to the heart - the coronary arteries) and of the heart muscles.  

There are no tests that can specifically diagnose Kawasaki disease. Blood tests can help suggest this diagnosis. Once Kawasaki disease is diagnosed, treatment should begin immediately to prevent the heart from being affected. Heart-related complications usually occur several days after other symptoms. Rapid recovery from early symptoms is expected following treatment. However, without treatment, patients usually recover eventually, but they continue to have an increased risk for coronary problems. 

Two drugs are used to treat Kawasaki disease. The first, immunoglobulin (IVIG), must be given through an IV (intravenous) line in the first week or so of illness. This significantly reduces risks to the coronary arteries that supply blood to the heart. The condition typically improves within 24 hours after IVIG. This medication can be repeated if the child does not demonstrate significant improvement. 

The other, aspirin, is given initially in high doses to reduce the inflammation. The dosage is then reduced and continued for at least 6 weeks and possibly months to years if heart disease is suspected.

Other drugs, such as acetaminophen (Tylenol), are not effective. The goal of treatment is to prevent the coronary arteries from being affected. If they are affected, serious conditions, such as heart attack, may occur. It is not felt that the use of aspirin in this situation results in an increased risk of Reye’s syndrome. There is debate as to whether the use of other anti-inflammation medications such as steroids are useful in the treatment of acute Kawasaki disease.

Examining the coronary arteries using ultrasound (echocardiography) is critical. It should be done shortly after the diagnosis is made, and usually around 6 weeks later to see if there have been any changes. If a child has problems with the coronary arteries, the patient will need long-term follow up with his or her cardiologist.

Kawasaki disease is mainly treated with medicines. Rarely, medical procedures and surgery may be used for children whose coronary (heart) arteries are affected.

The goals of treatment include:

  • Reducing fever and inflammation to improve symptoms
  • Preventing the disease from affecting the coronary arteries

Initial treatment

Kawasaki disease can cause serious complications. Therefore, your child will likely be treated in a hospital, at least for the early part of the treatment.

The standard treatment during the disease's acute phase is high-dose aspirin and immune globulin. Immune globulin is a medicine given intravenously (injected into a vein).

Most children who receive these treatments improve greatly within 24 hours. For a small number of children, fever remains. These children may need a second round of immune globulin.

At the start of treatment, high doses of aspirin are given. As soon as your child's fever goes away, a low dose of aspirin is given. The low dose helps prevent blood clots, which can form in the inflamed small arteries.

Most children treated for Kawasaki disease fully recover from the acute phase and don't need any further treatment. They should, however, follow a healthy diet and adopt healthy lifestyle habits to lower their risk of future heart disease.

This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

Your child’s doctor will talk with you about specific care for your child. Some general guidelines to follow may include these medicines:

  • Aspirin is given for up to 12 weeks, or longer with heart problems.
  • Immune Globulin is given intravenously (IGIV) in the hospital.
  • Other medicines may be given to treat complications

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.