Intravenous immunoglobulin (IVIG) reduces coronary aneurysms in patients with Kawasaki disease (KD), but additional management options remain challenging, with no generalisable evidence-based recommendations. We performed a survey of 724 physicians from 73 countries to assess variation in practice. IVIG was the preferred initial treatment by 659 (91%) of respondents. Criteria for adjunctive primary treatment varied considerably and definitions of IVIG resistance varied markedly by geographical continent, Human Development Index tiers and medical specialty. A second dose of IVIG was used most often for patients with coronary aneurysm non-responsive to initial treatment (572, 79%), but corticosteroids (379, 52%) and tumour necrosis factor alpha inhibitors (208, 29%) were also frequently used. Our findings highlight the need for international collaborative efforts to optimise management of patients with KD worldwide.
- Kawasaki disease
- intravenous immunoglobulin
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Contributors AD conceptualised and designed the study, collected the data, interpreted the data, drafted the initial manuscript and reviewed and revised the manuscript. DB, SF, DS-G, JN and ND conceptualised and designed the study, interpreted the data and critically reviewed the manuscript for important intellectual content.
Funding Funding was secured from the McCance Family Foundation (JWN), the Vella Fund (JWN) and BoBeauCoeur – Fondation CHU Ste-Justine (ND). DB is supported by a National Health and Medical Research (Australia) Senior Research Fellowship.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Not required.
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