Establish diagnosis
|
(1) Complete Kawasaki disease (any age) |
(2) Incomplete Kawasaki (<1 year) |
IVIG 2 g/kg as a single infusion over 12 hours |
Aspirin 30–50 mg/kg/day in 4 divided doses |
Echocardiography and ECG |
Aspirin 2–5 mg/kg/day when fever settled (disease defervescence) continuing for a minimum of 6 weeks |
Disease defervescence
|
Repeat echocardiography at 2 and 6 weeks |
No CAA
|
CAA <8 mm, no stenoses
|
CAA > 8 mm and/or stenoses
|
Stop aspirin at 6 weeks | Continue aspirin | Lifelong aspirin 2–5 mg/kg/day |
Lifelong follow up at least every 2 years | Repeat echocardiography and ECG at 6 monthly intervals | Consider warfarin |
| Discontinue aspirin if resolves | Consider coronary aneurysm angiography and exercise stress testing |
| Consider exercise stress test if multiple aneurysms | Repeat echocardiography and ECG at 6 monthly intervals |
| Specific advice on minimising atheroma risk factors | Specific advice on minimising atheroma risk factors |
| Lifelong follow up | Lifelong follow up |
No disease defervescence within 48 hours, or disease recrudescence within 2 weeks Seek expert advice to consider: |
Second dose of IVIG at 2 kg/kg/day |
Pulsed methylprednisolone at 600 mg/m2 twice daily for 3 days, or prednisolone 2 mg/kg/day once daily, weaning over 6 weeks |