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PICO
Question: Among children with severe Kawasaki disease, does adding prednisolone to intravenous immunoglobulin decrease coronary artery abnormalities?
Question type: Intervention
Study design: Randomized controlled
Investigators from 74 Japanese hospitals studied children with severe Kawasaki disease (KD) between 2008 and 2010 to determine if adding prednisolone to intravenous immunoglobulin (IVIG) therapy reduced the incidence of coronary artery abnormalities. Eligible patients included those with KD based on Japanese diagnostic guidelines1 and risk score ≥5 for initial treatment failure. The risk score assigns 2 points each for serum sodium ≤133 mmol/L, ≤4 days of illness at time of diagnosis, aspartate amino transferase ≥100 U/L, and white blood differential count of ≥80% neutrophils; and 1 point each for platelet count ≤30,000/μL, C-reactive protein ≥100 mg/L, and age ≤12 months.
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