Medications for the treatment of Kawasaki disease

Nov 25, 2025 Source: Cainiu Health

Dr. Zhou Xiaofeng

Introduction

The main medications for treating Kawasaki disease include intravenous immunoglobulin (IVIG), aspirin, corticosteroids, anticoagulants, and immunomodulatory agents, which should be used appropriately according to the severity of the condition and the stage of the disease. If a child develops persistent high fever, conjunctival congestion, swelling of the hands and feet, or similar symptoms, prompt medical evaluation is recommended.

Kawasaki disease is primarily treated with medications including intravenous immunoglobulin (IVIG), aspirin, corticosteroids, anticoagulants, and immunomodulatory agents. The choice of treatment should be based on the severity of the condition and the stage of the disease. If a child develops persistent high fever, conjunctival congestion, or swelling of the hands and feet, immediate medical evaluation is recommended.

1. Intravenous immunoglobulin (IVIG): This is the core treatment. Administered within 10 days of symptom onset, it rapidly suppresses systemic inflammation and reduces the risk of coronary artery damage. Most children experience a quick return to normal body temperature after a single infusion.

2. Aspirin: Used in high doses during the acute phase for its anti-inflammatory effects, helping to relieve symptoms such as fever and joint pain. After fever subsides, low-dose aspirin is continued for its anticoagulant effect to prevent coronary artery thrombosis. Dosage must be carefully adjusted according to body weight.

3. Corticosteroids: Reserved for patients who do not respond well to IVIG or those with severe disease. They provide potent anti-inflammatory effects and help reduce vascular injury. These should be used short-term under physician supervision to avoid adverse effects associated with long-term use.

4. Anticoagulant drugs: In addition to low-dose aspirin, high-risk patients may require additional agents such as clopidogrel to enhance anticoagulation and prevent progression of coronary artery abnormalities. Coagulation function should be monitored regularly during treatment.

5. Immunomodulatory agents: Used as adjunctive therapy in refractory Kawasaki disease to modulate immune function and improve anti-inflammatory response. They are combined with other treatments to enhance efficacy and must be administered according to strictly individualized treatment plans.

During treatment, ensure the child gets adequate rest, provide a light and easily digestible diet, and maintain sufficient hydration and nutritional intake. Closely monitor body temperature, rash, and mental status, and avoid strenuous physical activity. Regular follow-up echocardiograms should be performed as prescribed to monitor coronary artery status.

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