Do Corticosteroids Improve Outcome in Kawasaki Disease?
Kawasaki disease (KD) is a mucocutaneous vasculitis apparently triggered by an unknown infectious agent in infants and young children with a genetic predisposition. It is the leading cause of acquired heart disease in children. In Japan, KD affects 1 in every 185 children. In the multiethnic U.S., that figure is about 25 children per 100,000 (5000 new cases annually). Diagnosis rests on a constellation of clinical signs that often emerge over time, including rash, fever, conjunctivitis, erythema of the lips and oral mucosa, and cervical lymphadenopathy. There is no single diagnostic test. Untreated, KD leads to coronary artery aneurysms in up to 25% of children. Standard therapy is intravenous immunoglobulin (IVIG) and high-dose aspirin given within the first 10 days of illness. Even with early treatment, approximately 5% of children develop coronary artery aneurysms, 1% develop giant aneurysms, and some develop recurrent KD. Until now, studies of the value of adding systemic corticost
