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IVIG-resistant Kawasaki Disease
Some patients do not respond to IVIG infusion, and this incidence could be as high
as 10% to 26%. IVIG-resistant Kawasaki Disease is defined as persistent or
recrudescent fever after 36 hours of completion of IVIG.
In this group of patients, we shall give a 2 dose of IVIG (2g/kg as a single infusion
nd
over 10 to 12 hours), or we should add methylprednisolone to the treatment. Some
centres use infliximab. There is a study on the usage of Anakinra in this group of
patients. In very resistant cases, in some centres, these are the other drugs
(Cyclophosphamide, Cyclosporine, Ulinistatin) that have been used. One of the
centres uses plamapheresis as the second line drug as well.
