Recommended guideline for the management of Kawasaki disease in the UK
| 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 | ||