Vascular disease: Corticosteroid therapy improves outcomes for Japanese children with Kawasaki disease

摘要

Results from a ground-breaking study published in the Lancet show that the addition of prednisolone to primary immunoglobulin therapy reduces the incidence of coronary artery defects in patients with severe Kawasaki disease. "Many pediatricians have hesitated to use corticosteroids for Kawasaki disease," explains first author of the Lancet paper, Tohru Kobayashi, "[our study] broke this 'urban legend'" Kawasaki disease (also known as mucocutaneous lymph node syndrome) is a rare, systemic vasculitis of unknown etiology. The condition, first described in Japan by Tomisaku Kawasaki in 1967, primarily affects children aged <5 years. Although the disease is most common in Asia, cases have been reported in developed countries worldwide. Kawasaki disease is characterized by skin rashes and swelling caused by inflammation of the blood vessels, accompanied by fever. Progression of the disease can lead to coronary artery anomalies through cellular infiltration and destruction of the vessel lamina. Early treatment of Kawasaki disease is, therefore, vital to prevent these cardiovascular sequelae.