MANAGEMENT OF KAWASAKI DISEASE: AN EVIDENCE-BASED APPROACH

Key words: Kawasaki disease, Coronary risk, Immunoglobulins

The aetiology of Kawasaki disease is unknown. The highest incidence is in children aged less than 5 years. Its typical forms are diagnosed on the basis of criteria which include, in addition to fever lasting more than 5 days, the presence of 4 additional signs (bilateral conjunctivitis, laterocervical lymphadenomegaly, rash, mucositis, alterations of fingers and toes). Atypical forms are relatively common and should always be taken into account in case of persisting fever. Two atypical cases are reported. The assessment of coronary risk is based on clinical and laboratory data. Treatment with immunoglobulins (2 g/kg) reduce the risk of coronary aneurysms. In case of lack of response (10-20% of cases), a new dose of immunoglobulins should be administered. The use of steroids in non-responders has recently been proposed.