The treatment of Kawasaki disease is a medical priority, as the condition can lead to serious complications if not addressed swiftly—particularly coronary artery aneurysms.
Treating it early—within the first 10 days—lowers the chance of heart problems later on. The main goal is to calm the strong inflammation that affects the blood vessels, especially the ones that supply the heart. Other goals include lowering the fever, easing symptoms, and keeping the heart healthy in the long run.
Doctors use a mix of medicines, supportive care, and regular follow-ups with heart experts. These steps have greatly improved how children recover. But early diagnosis still plays the biggest role in helping kids get better.
1. First-Line Treatment: Intravenous Immunoglobulin (IVIG)
The most important treatment of Kawasaki disease is intravenous immunoglobulin (IVIG). It’s usually given as one large dose—2 grams per kilogram—over 10 to 12 hours. Doctors try to give IVIG within the first 10 days of illness. Even if given later, it can still help if the child has symptoms or inflammation.
IVIG works by calming the immune system and lowering body-wide inflammation. It helps fast—over 85% of children feel better within 36 hours, and their fever goes down. This treatment also cuts the risk of heart artery problems from 25% to under 5%.
If the fever doesn’t go away within 36 hours, doctors may give another dose or try different treatments.
2. Aspirin Therapy
Aspirin plays a big role in treating Kawasaki disease. Though doctors usually avoid aspirin in children, it’s safe here under medical care. Aspirin helps in two ways:
- At first, high doses (30–100 mg/kg/day) bring down the fever and swelling.
- Later, low doses (3–5 mg/kg/day) help prevent blood clots, especially in kids with heart problems.
If the child has no signs of artery issues, aspirin may be stopped after 6–8 weeks. But if aneurysms are present, they may need to stay on aspirin longer or even add other blood-thinning medicines.
3. Corticosteroids in Treatment of Kawasaki Disease
Doctors now use steroids in some cases to improve recovery. Corticosteroids like prednisolone or methylprednisolone are helpful when:
- The child is younger than 6 months
- Kawasaki disease is incomplete
- Early heart changes are already seen
- The child does not get better after IVIG
Steroids slow down the immune system’s attack and ease swelling in the vessels. When given early with IVIG, they can lower the chances of heart artery problems.
4. Handling IVIG-Resistant Kawasaki Disease
Around 10–15% of children don’t respond to the first IVIG treatment. These children need extra help. Treatment may include:
- A second IVIG dose
- Steroids—either IV or as pills
- Infliximab—a medicine that blocks a chemical called TNF
- Other immune treatments like cyclosporine or anakinra in rare cases
These children need close heart checks, as they have a higher risk of artery problems.
5. Supportive Care
Besides the main treatments, supportive care makes a big difference. This includes:
- Hydration: Kids lose fluids from fever and not eating, so they need enough fluids.
- Food support: If eating is hard, soft and tasty food helps.
- Pain relief: Paracetamol (not aspirin) may help early on, before doctors confirm the diagnosis.
- Careful watching: A hospital stay helps doctors catch problems early—heart, brain, or stomach-related.
Most kids stay in the hospital for 3–7 days, depending on how sick they are and how fast they recover.
6. Heart Monitoring and Follow-Up
Because the disease can harm the heart, doctors keep checking the heart for weeks or months afterward. This includes:
- Heart scans (echocardiograms): Done at diagnosis, two weeks later, and again at 6–8 weeks
- ECG tests: To check the heart’s rhythm
- Advanced scans: CT or MRI for children with artery aneurysms
Kids with big aneurysms may need checkups even as teens or adults. They also need heart-healthy habits and may take medicine long-term to protect their hearts.
7. Exercise and Activity
Most children can go back to playing and school once the fever is gone and they stop high-dose aspirin. But those with artery problems must avoid heavy exercise for a while. Doctors will guide the family based on the child’s heart condition.
8. Vaccine Timing After Treatment of Kawasaki Disease
Kids who get IVIG need to wait before getting live vaccines like MMR or chickenpox. The delay is about 11 months. This is because IVIG can affect how well vaccines work. Other vaccines can usually stay on schedule. Talk to your child’s doctor to plan the right timing.
9. Helping Parents Understand and Cope
Having a child with Kawasaki disease is stressful. Parents need clear support. Doctors should give:
- Easy-to-follow info about medicine and side effects
- A plan for follow-up visits and heart tests
- Signs to watch for, like chest pain or extreme tiredness
- Reassurance about recovery and long-term health
Both paediatricians and heart doctors work closely with families throughout recovery.
Final Thoughts
The treatment of Kawasaki disease has come a long way, and when started early, it works very well. IVIG and aspirin remain the most effective tools. Steroids and newer immune medicines help in harder cases. But recovery isn’t just about medicine.
A full care plan—including regular heart checks, family support, and planning for the future—is key to helping children heal. Most children recover well and return to normal life, thanks to early and thorough care.
