Adverse effects of methylprednisolone pulse therapy in refractory Kawasaki disease

The efficacy and safety, including arrhythmia and sudden death,1,2 of intravenous methylprednisolone pulse (IVMP) therapy in patients with Kawasaki disease (KD) are uncertain. We conducted a control study in KD patients with persistent or recurrent fever (⩾37.5°C) 48 hours after a single infusion of initial intravenous immunoglobulin (IVIG) 2 g/kg. At enrolment (day 1), the subjects were randomised to receive IVMP (30 mg/kg/day of methylprednisolone for three days), or additional IVIG (2 g/kg). Heparin was also continuously infused (15–20 units/kg/h) in the IVMP group. The study was halted prematurely because of …