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Steroids reduce heart damage risk in children with Kawasaki's disease

When added to standard treatment, steroids significantly reduce the odds of developing heart damage in children with Kawasaki's disease, according to a study in the October issue of Pediatrics. These findings address a gap in knowledge. Current guidelines from the American Academy of Pediatrics state that the evidence for steroid treatment is lacking and recommend the standard treatment for Kawasaki's, which is aspirin and intravenous immunoglobulin (IVIG).

"This gap in knowledge led us to examine the benefits of steroids more closely. We looked at research worldwide and were surprised to find eight solid clinical trials showing the value of steroids in significantly reducing heart damage in children with Kawasaki's disease. Steroids, when combined with aspirin and IVGB, reduced the odds of developing inflammation of the heart blood vessels by half," said Stephen Aronoff, MD, lead author of the meta-analysis and Temple University School of Medicine professor and chair of pediatrics.

Aronoff hopes that a multi-center study, currently underway, will provide further evidence of the benefits of steroid treatment for Kawasaki's disease. Also needed is more evidence about the most effective types and doses of steroids.

Kawasaki's disease, one of the leading causes of acquired heart disease in children, inflames the blood vessels leading to the heart. The cause of Kawasaki's is unknown. Signs of the disease include fever lasting longer than 5 days, skin rash, red eyes, palms and foot soles and swollen lymph nodes. If not treated within five to ten days, it can lead to serious, sometimes life-threatening, complications. Fortunately, Kawasaki's is treatable and most children recover fully.

Temple University. October 2005.