treatment for patients with kawasaki disease who are resistant to IVIG therapy

What is the treatment for patients with kawasaki disease who are resistant to IVIG therapy?

IVIG resistance is defined as fever that occurs from 36 hours to 7 days after the end of the IVIG infusion. Between 10% and 35% of patients with KD are IVIG-resistant. There are no current consensus guidelines regarding what is the optimal therapy for patients who are IVIG-resistant. Options for therapy include administration of a second dose of IVIG (2 g/kg), infliximab (5 mg/kg), or high-dose pulse steroids (20–30 mg/kg intravenously for 3 days with or without a subsequent course and taper of oral prednisone). For patients with refractory KD who fail to respond to a second course of IVIG, infliximab, and/or steroids, other therapies to consider include anakinra, cyclosporine, or plasma exchange.

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