Methylprednisolone pulse therapy for massive lymphadenopathy in a child with intravenous immunoglobulin-resistant Kawasaki disease

Hsin-Hsu Chen¹, Po-Mai Liu¹, Chin-Nam Bong², Yu-Tsun Wu³, Kuender D. Yang¹, Chih-Lu Wang^1
1Department of Pediatric Allergy, Immunology and Rheumatology, Chang Gung Children's Hospital, Kaohsiung; ²Department of Pediatrics, Pingtung Christian Hospital, Pingtung; and ³Department of Pediatrics, Yunlin Huwei St. Joseph Hospital, Yunlin Hsien, Taiwan

Received: April 16, 2004 Revised: June 24, 2004 Accepted: July 1, 2004

Corresponding author: Chih-Lu Wang, MD, PhD, Department of Pediatric Allergy, Immunology and Rheumatology, Chang Gung Childrens Hospital, 123, Ta-Pei Road, Niaosung Hsiang, Kaohsiung 833, Taiwan. E-mail:

Kawasaki disease (KD) is an acute febrile multi-system vasculitis of unknown etiology. The diagnosis is based on clinical features. We describe a case of intravenous immunoglobulins (IVIG)-resistant KD presenting with persistent fever and massive cervical lymphadenopathy associated with mild respiratory distress. The symptoms resolved after methylprednisolone pulse therapy. High-dose pulse steroid may be an alternative therapeutic option in KD which presents with possible life-threatening complications or failure to respond to high-dose IVIG infusion.

Key words: Drug pulse therapy, intravenous immunoglobulins, methylprednisolone, mucocutaneous lymph node syndrome

J Microbiol Immunol Infect2005;38:149-152.