Table 2

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 weeksContinue aspirinLifelong aspirin 2–5 mg/kg/day
Lifelong follow up at least every 2 yearsRepeat echocardiography and ECG at 6 monthly intervalsConsider warfarin
Discontinue aspirin if resolvesConsider coronary aneurysm angiography and exercise stress testing
Consider exercise stress test if multiple aneurysmsRepeat echocardiography and ECG at 6 monthly intervals
Specific advice on minimising atheroma risk factorsSpecific advice on minimising atheroma risk factors
Lifelong follow upLifelong 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