Approach to resistant IVIG Kawasaki disease in children

Kawasaki disease (KD) is an acute febrile illness of early childhood characterized by vasculitis of the medium-sized arteries. There is no diagnostic test for KD because the cause is unknown, so diagnosis relies on the recognition of the diagnostic clinical criteria. The most feared sequela of KD is development of coronary artery abnormalities, which occur in 20-25% of untreated children. IVIG reduces this risk in 2-5% when administrated within 10 days from the onset of fever. Here is reported the case of an infant which resulted resistant to 2 consecutive doses of IVIG. Glucocorticoids are recommended as an appropriate therapy in IVIG resistant Kawasaki disease.