Adding infliximab to standard therapy with high-dose intravenous immunoglobulin plus high-dose aspirin may decrease fever duration and prevent coronary artery lesions in children with Kawasaki disease, study findings indicate.

medwireNews : The American College of Rheumatology (ACR) and the Vasculitis Foundation have issued evidence-based recommendations and expert guidance on managing Kawasaki disease (KD).

Italian researchers report a 30-fold increase in the incidence of severe Kawasaki-like disease with the emergence of COVID-19. Read the linked commentary from Sangeeta Sule .

Initial treatment with low-dose aspirin alongside intravenous immunoglobulin is not associated with an increased risk for recrudescent fever relative to high-dose aspirin in children with Kawasaki disease, US research shows.

The interleukin-1 receptor inhibitor anakinra merits further investigation for the treatment of Kawasaki disease, suggest findings from a phase IIa trial presented at the EULAR 2019 congress in Madrid, Spain.

Findings from the KAICA trial suggest that adding ciclosporin to intravenous immunoglobulin treatment may reduce the risk for coronary artery abnormalities among patients with Kawasaki disease.

de Ferranti SD et al. JAMA Pediatr  2018: e183310. doi: 10.1001/jamapediatrics.2018.3310

Vaccination well tolerated in patients with Kawasaki disease The final study used electronic medical records from 2020–2022 to describe the safety outcomes of 153 patients with Kawasaki disease (KD) aged an average of 13 years (range 5–21 years) who received at least one dose of an mRNA COVID-19 vaccine, primarily the Pfizer–BioNTech vaccine (93.5%).

Their levels were also significantly lower than in two tested control groups (Kawasaki disease and JIA) and this remained the case after excluding two MIS-C patients who had received intravenous Ig prior to having blood samples taken.

Human leucocyte antigen-DRB1*15 haplotypes are strongly associated with delayed drug reaction with eosinophilia and systemic symptoms in people receiving IL-1 or IL-6 inhibitors for Still’s disease, research suggests.

Schulert et al report that patients with MIS-C had “similar” levels of S100A8/A9, S100A12, and IL-18 to those with Kawasaki disease, but these markers “performed well” in differentiating Kawasaki disease from systemic JIA, with sensitivity and specificity values of 100% when respective cutoffs of 29,577 ng/mL, 1984 ng/mL, and 2632 pg/mL were used.

Comment on:  COVID-19 linked to outbreak of severe Kawasaki-like disease

The guidance advises on the diagnosis of MIS-C, discusses the similarities and differences relative to Kawasaki disease, and provides recommendations on cardiac management, immunomodulatory treatment, and antiplatelet and anticoagulation therapy.

Comment on:  IVIG–ciclosporin combination may improve coronary artery outcomes in Kawasaki disease