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Controversies in the medical management of Kawasaki disease

Published online by Cambridge University Press:  19 August 2008

Elfriede Pahl*
Department of Pediatrics, Division of Pediatric Cardiology, Children's Hospital of Pittsburgh and the University of Pittsburgh School of Medicine, Pittsburgh
William H. Neches
Department of Pediatrics, Division of Pediatric Cardiology, Children's Hospital of Pittsburgh and the University of Pittsburgh School of Medicine, Pittsburgh
José A. Ettedgui
Department of Pediatrics, Division of Pediatric Cardiology, Children's Hospital of Pittsburgh and the University of Pittsburgh School of Medicine, Pittsburgh
Dr. Elfriede Pahl, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA


Summary Mucocutaneous lymph node syndrome, now called Kawasaki disease, affects children of all ages and races. The cause of this systemic vasculitis is unknown, thus the diagnosis is based solely on clinical criteria. Coronary arteritis and the formation of coronary arterial aneurysms are the most serious early cardiac complications, while long term sequels, such as coronary stenosis and myocardial infarction, may occur. Current medical therapy is aimed solely at preventing or decreasing the occurrence of these cardiovascular complications in patients with this disease. Past treatment included antibiotics, steroids, and nonsteroidal anti-inflammatory agents. Aspirin remains the most widely used drug, although the use of intravenous gammaglobulin has also become common. When used in combination, these two agents may reduce the incidence of coronary arterial aneurysms. The optimal dosage and duration of treatment has not yet been determined.

The World Forum for Pediatric Cardiology Symposium on Kawasaki Disease
Copyright © Cambridge University Press 1991

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