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IVIg-resistant Kawasaki disease — RACP Paediatrics MCQ

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ModerateCardiologyIVIg-resistant Kawasaki diseaseRACP Paediatrics

A 4-year-old was diagnosed with Kawasaki disease and treated with IVIg and aspirin. 48 hours after completing the IVIg infusion, the child remains febrile (39.2°C). What is the most appropriate next step?

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Correct answer: B — Second dose IVIg 2 g/kg

IVIg resistance is defined as persistent or recurrent fever ≥38°C at 36 hours or more after completion of the first IVIg infusion. Per the RCH Melbourne KD CPG, a second dose of IVIg 2 g/kg is the recommended first-line retreatment. Corticosteroids or infliximab may be considered for refractory cases.

Reference: RCH Melbourne – 2024 – Kawasaki Disease CPG