A. Intravenous Gamma Globulin Therapy
Coronary artery abnormalities such as aneurysm and thrombosis are reduced by treatment with intravenous gamma globulin 2 g/kg in a single infusion over 10–22 hours given within the first 10 days of illness. But more than 5% of children treated develop dilatation of the coronary arteries and in ~1% giant aneurysms develop. Intravenous therapy is repeated if there is occurrence of fever for more than 48 h.
B. Aspirin
The anti-inflammatory actions of moderate doses of aspirin are useful in controlling fever, then the dose is reduced to approximately 5 mg/kg/day for 8 weeks. This small dose inhibits platelet aggregation and may prevent thrombosis. Treatment with aspirin does not prevent formation of aneurysms. During the assumed recovery phase, coronary artery vasculitis may precipitate myocardial infarction.
C. Corticosteroids
Some studies indicate that the use of steroids prevents the occurrence of coronary artery aneurysms. As with other conditions that cause vasculitis, corticosteroids appear to quench the fiery stage but they are not curative.
Antithrombotic agents and occasionally coronary artery bypass graft is required to treat Kawasaki disease. Further research is required to uncover the etiologic process of this disease and its pathogenesis in order to develop logical therapeutic strategies.