Intravenous immunoglobulin for management of Kawasaki disease
Seek urgent specialist advice if there is a high index of suspicion for Kawasaki disease to determine if immediate treatment is required (eg intravenous immunoglobulin).
In children with Kawasaki disease, the risk of coronary artery aneurysm formation is reduced (from around 30 to 3%) by treatment with intravenous immunoglobulin (IVIg)1. Ideally, IVIg should be given when the diagnosis is confirmed, and preferably within 10 days of disease onset (unless the diagnosis was missed earlier and there is ongoing evidence of systemic inflammation)Ig Governance, 2021. The usual dosage of IVIg for Kawasaki disease is:
intravenous immunoglobulin (IVIg) 2 g/kg intravenously, as a single infusion over 10 to 12 hours. intravenous immunoglobulin (IVIg) intravenous immunoglobulin (IVIg)
Monitor patients for persistent or recurrent fever for 24 to 48 hours after the IVIg infusion.
A second IVIg infusion may be given for Kawasaki disease if fever persists or recurs 36 hours or more after completion of the initial infusion. Alternatively, the specialist may consider immunomodulatory drugs.