Are steroids contraindicated in Kawasakis disease?
(Dr Sujata Sawhney) Until about a decade ago steroids were contraindicated in Kawasaki disease. This followed a publication by Kato et al in 1979, which suggested that patients who receive steroids had a very high incidence of coronary artery aneurysms. This study was however followed by several subsequent publications by Nonaka, Shinohara and Hashino, all of which showed that glucocorticoids are helpful in reducing duration of fever and also in the rapid improvement in markers of inflammation. No study has thus far been able to decisively show the influence of steroids on coronary artery outcomes. Currently steroids are used in patients with persistent disease regardless of two doses of IVIG. The role in the initial treatment of Kawasaki disease is not well defined to date. References • Kato H, Koike S, Yokoyama T. Kawasaki disease: effect of treatment on coronary artery involvement. Pediatrics 1979;63:175–9. Nonaka Z Maekawa K, Okabe T, et al. Randomized controlled study of intraveno
