Methylprednisolone as an alternative therapy for Kawasaki disease: case series

  • Yudha Fadhol Arafah Gadjah Mada University
  • Sasmito Nugroho
  • Noormanto Noormanto
  • Nadya Arafuri
  • Indah Kartika Murni
Keywords: methylprednisolone; Kawasaki disease;

Abstract

Kawasaki disease (KD), or mucocutaneous syndrome, is an acute, systemic vasculitis of small- and medium-sized arteries that predominantly affects patients younger than five years.1  KD is the leading cause of childhood acquired heart disease in the developed world.2 The incidence in those aged under 5 years varies widely throughout the world, accounting for 8.4 per 100,000 in the UK, 17.5 to 20.8 per 100,000 in the USA, and 239.6 per 100,000 in Japan.2

The diagnosis of classic KD is based on the simultaneous presence of high fever for 5 or more days with at least four of five other symptoms (bilateral conjunctival hyperemia, ulcerations of the lips and inflammation of the oral cavity, polymorphous rash, edema and desquamation of the extremities, and cervical lymphadenopathy), or fever associated with less than 4 of the diagnostic criteria and echocardiographic abnormalities of the coronary arteries.3

Author Biographies

Sasmito Nugroho

Department of Child Health, Universitas Gadjah Mada Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java

Noormanto Noormanto

Department of Child Health, Universitas Gadjah Mada Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java

Nadya Arafuri

Department of Child Health, Universitas Gadjah Mada Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java

Indah Kartika Murni

Department of Child Health, Universitas Gadjah Mada Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java

References

1. Saguil A, Fargo M, Grogan S. Diagnosis and management of kawasaki disease. Am Fam Physician. 2015;91(6):365-71. PMID: 25822554.
2. Wardle AJ, Connolly GM, Seager MJ, Tulloh RM. Corticosteroids for the treatment of Kawasaki disease in children. Cochrane Database Syst Rev. 2017;1:CD011188. DOI: 10.1002/14651858.CD011188.pub2.
3. Leonardi S, Barone P, Gravina G, Parisi GF, Di Stefano V, Sciacca P, et al. Severe Kawasaki disease in a 3-month-old patient: A case report. BMC Res Notes. 2013;6:500. DOI: 10.1186/1756-0500-6-500.
4. Miura M, Tamame T, Naganuma T, Chinen S, Matsuoka M, Ohki H. Steroid pulse therapy for Kawasaki disease unresponsive to additional immunoglobulin therapy. Paediatr Child Health. 2011;16:479–84. DOI: 10.1093/pch/16.8.479
5. Hung JJ, Chiu CH. Pulse methylprednisolone therapy in the treatment of immune globulin-resistant Kawasaki disease: case report and review of the literature. Ann Trop Paediatr. 2004;24:89–93. DOI: 10.1179/027249304225013330
6. McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: A scientific statement for health professionals from the American Heart Association. Circulation. 2017;135:927-99. DOI: 10.1161/CIR.0000000000000484
7. Zhu BH, Lv HT, Sun L, Zhang JM, Cao L, Jia HL, et al. A meta-analysis on the effect of corticosteroid therapy in Kawasaki disease. Eur J Pediatr. 2012;171:571-8. DOI: 10.1007/s00431-01101585-4
8. Miura M. Role of glucocorticoids in Kawasaki disease. Int J Rheum Dis. 2018;21:70-5. DOI: 10.1111/1756-185X.13209
9. Yu JJ. Use of corticosteroid during acute phase of Kawasaki disease. World J Clin Pediatr. 2015;4:135-42. DOI: 10.5409/wjcp.v4.i4.135
10. Shinohara M, Sone K, Tomomasa T, Morikawa A. Corticosteroids in the treatment of the acute phase of Kawasaki disease. J Pediatr. 1999;135:465-9. DOI: 10.1016/s0022-3476(99)70169-1
11. Inoue Y, Okada Y, Shinohara M, Kobayashi T, Kobayashi T, Tomomasa T, et al. A multicenter prospective randomized trial of corticosteroids in primary therapy for Kawasaki disease: clinical course and coronary artery outcome. J Pediatr. 2006;149:336-41. DOI: 10.1016/j.jpeds.2006.05.025
12. Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health Professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics. 2004;114:1708-33. DOI: 10.1542/peds.2004-2182
Published
2020-08-14
How to Cite
1.
Arafah Y, Nugroho S, Noormanto N, Arafuri N, Murni I. Methylprednisolone as an alternative therapy for Kawasaki disease: case series. PI [Internet]. 14Aug.2020 [cited 22Dec.2024];60(5):283-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2172
Section
Case Report
Received 2019-03-30
Accepted 2020-08-14
Published 2020-08-14