Kawasaki Disease

Kawasaki Disease (KD) is a systemic vasculitis primarily affecting children under 5, causes inflammation in medium-sized arteries, notably the coronary arteries, and can lead to severe complications like coronary artery aneurysms if untreated, increasing long-term cardiovascular risks. The primary treatment, high-dose intravenous immunoglobulin (IVIG), significantly reduces these risks, but 10-20% of patients exhibit IVIG resistance, necessitating additional therapies and heightening the risk of coronary abnormalities. This review examines the mechanisms of IVIG resistance, identifies clinical and genetic risk factors, and evaluates predictive models for early detection to improve management and outcomes for IVIG-resistant KD patients. It emphasizes that resistant cases face a higher risk of coronary artery aneurysms, potentially causing life-threatening conditions like myocardial infarction. Research, including Arai et al. (2020), indicates up to 30% of resistant patients develop severe coronary complications, while Shimizu et al. (2021) link genetic polymorphisms in immunomodulatory genes to resistance, underscoring the need for personalized treatments and enhanced predictive models to optimize patient outcomes.