Kawasaki Disease

Treatment

Mayo Clinic doctors who have training in treating infectious diseases, doctors who have training in treating children who have heart disease (pediatric cardiologists) and other specialists work as a team to treat children who have Kawasaki disease. Children needing hospitalization receive care at Mayo Eugenio Litta Children's Hospital.

Your child's treatment team determines the most appropriate treatment based on:

• Age, overall health and medical history
• The stage of disease when diagnosed
• Tolerance for medications, procedures or therapies
• Expectations for the course of your child's condition
• Your preference

Kawasaki disease treatment is most effective if given in the first 10 days of your child's illness. Kawasaki disease occurs in three phases, and then generally the signs and symptoms disappear after approximately 12 days. Sometimes your child may have complications which require further treatment.

Treatment options include:

• Gamma globulin. Your child's doctor may infuse an immune protein (gamma globulin) through your child's vein (intravenous) to help prevent coronary artery damage. This treatment is most effective if your child receives it within the first 10 days of illness. Your child's doctor will monitor your child during the administration of gamma globulin, as children react differently to this drug.
• Aspirin. Your child's doctor prescribes aspirin to decrease inflammation, lower fever and help prevent blood clots. Generally, your child's doctor prescribes high doses of aspirin in the first few days of your child's illness to control fever. Once your child's fever has been reduced for two to three days, your child's doctor will decrease the dose. Children continue to take a low dose of aspirin for several weeks and then may stop taking the drug, unless they have coronary artery damage. Your child may have both gamma globulin and aspirin as part of his or her treatment.
• Follow-up. Your child's pediatric cardiologist will evaluate your child for any changes in the coronary arteries with regular echocardiograms and appointments. If the echocardiogram shows the coronary arteries are normal, your child won't need any additional treatment.

If your child has coronary artery problems, your child's pediatric cardiologist will continue long-term follow-up appointments and testing to monitor your child. Usually, your child's coronary artery changes disappear, but some children have significant coronary artery problems, including large aneurysms (blood-filled enlargement of an artery). If your child has coronary artery problems or other heart problems, your child may need to continue taking a low dose of aspirin.

Your child also may require further treatment for his or her cardiovascular problems, including:

• Anticoagulant drugs. These drugs help prevent blood clots from forming in your child's arteries.
• Coronary angioplasty and stents. In this procedure, your child's doctor inserts a catheter in your child's groin and threads it to your child's coronary arteries. Your child's doctor inflates a small balloon inside the blocked artery. The balloon widens the artery, allowing greater blood flow. Sometimes, your child's doctor may insert a small metal wire tube (stent) to keep the artery open permanently.
• Coronary artery bypass surgery. In coronary bypass surgery, your child's doctor will create a bypass around blocked arteries using a new blood vessel.