Methylprednisolone pulse therapy in Kawasaki disease

: A role of intravenous methylprednisolone pulse (IVMP) therapy has not been established for Kawasaki disease (KD) patients unresponsive to initial intravenous immunoglobulin (IVIG) therapy. We conducted a control study in 22 KD patients unresponsive to initial IVIG to compare IVMP with additional IVIG. IVMP induced faster but temporary resolution of fever and more adverse effects such as bradycardia. For the last four years, 62 KD patients unresponsive to initial IVIG have been treated with additional IVIG, and 17 unresponsive to additional IVIG with IVMP, followed by oral prednisolone. Among of them, coronary artery lesions were detected in two patients, but regressed in 6 months. This protocol may be useful for eradication of coronary artery lesions.