Kawasaki Disease: Laboratory Findings and an Immunopathogenesis on the Premise of a ""Protein Homeostasis System

Lee, Kyung-Yil; Rhim, Jung-Woo; Kang, Jin-Han

signs, and consequently they may be diagnosed and treated earlier. 18 Because of the limitations of early prediction for IVIG non-responders, some study groups have tried early aggressive treatment for prevention of CALs with IVIG (2 g/kg), aspirin, and methylprednisolone (30 mg/kg) or infliximab. However the results of these studies are controversial. 41, 56, 66, 67 This treatment policy also has some obstacles such as overtreatment of patients with mild clinical course; 85-90% of the patients respond to initial IVIG treatment (2 g/kg). Furthermore it was reported that ~80% of the patients responded to a medium-dose of IVIG (1 g/kg), 68 although high doses of IVIG are more effective in preventing CALs. 69 Thus, early detection of the severely affected patients among all KD patients and prompt further treatment of these patients is necessary because CALs develop and progress before the peak stage of the disease.