Refractory Kawasaki Disease-a Challenge for the Pediatrician

SN Compr Clin Med. 2021;3(3):855-860. doi: 10.1007/s42399-021-00775-w. Epub 2021 Jan 28.


Kawasaki disease (KD) is an acute, self-limiting febrile illness of childhood associated with vasculitis, mainly of the medium-sized arteries. The clinical significance and impact of this condition arise from its predilection for the coronary arteries. The criteria for classic Kawasaki disease are clearly defined, but many children present with atypical forms, and clinicians need to consider this possibility. Although most diagnosed cases respond to intravenous immunoglobulin (IVIG) and aspirin, some have proven resistant to the standard treatment. This article aims to provide a brief overview of Kawasaki disease, focusing on the resistant/refractory cases, and the treatment options available for such cases.

Keywords: Atypical Kawasaki disease; Coronary artery aneurysms; Coronary dilation; IV immunoglobulin; Infliximab; Intravenous immunoglobulin; Kawasaki disease; Plasma exchange; Refractory Kawasaki disease; Steroids.

Publication types

  • Review