Corticosteroids and Kawasaki

• Kato et al (1979): coronary complications incidence increased

• first treatment in other similar vasculitis

• case reports: success after IVIG failure

• Shinohara et al (1999): reduction of fever and coronary complication with prednisolone

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Corticoids are contraindicated in Kawasaki disease since a paper of 1979 which reported high incidence of coronary lesions after use of corticoids as only therapy. However, corticoids are gold standard treatment for a lot of other vasculitis. Currently, there is data supporting the efficacy of high doses corticoids in Kawasaki acute phase (30mg/kg/d, 1 to 3 days). At this time, recognised indication is the unresponsiveness to gammaglobulin therapy associated to presence of risk factor.