Which of the following is the treatment of choice for Kawasaki's disease?

SCTIMST Staff Nurse - 2016

Child Health Nursing (Pediatrics)

Easy

Appeared in: SCTIMST Staff Nurse - 2016

Explanation

Intravenous Immunoglobulin (IVIG) is the standard, first-line treatment for Kawasaki disease.
The primary goal of IVIG therapy is to reduce the systemic inflammation, particularly of the coronary arteries, to prevent the formation of aneurysms.
When administered within the first 10 days of illness, IVIG reduces the risk of coronary artery abnormalities from 20-25% to less than 5%.
IVIG is typically given as a single high dose (2 g/kg) along with aspirin.

Option A: Cyclosporine is an immunosuppressant used for severe, refractory cases, not as the initial treatment of choice.
Option B: Dapsone is an antibiotic with anti-inflammatory properties that has no established role in the treatment of Kawasaki disease.
Option D: Methotrexate is a disease-modifying antirheumatic drug (DMARD) that is not used for the acute management of Kawasaki disease.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological management of Kawasaki Disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The nurse's role in administering IVIG is critical. This includes verifying the dose, running the infusion over the correct duration (10-12 hours), and closely monitoring for infusion-related adverse reactions (e.g., fever, chills, hypotension, anaphylaxis).
Patient and family education is a key nursing responsibility. Families must understand the need to defer live vaccines (MMR, varicella) for 11 months post-IVIG, as the antibodies in IVIG can interfere with the vaccine's effectiveness.
Nurses must monitor for signs of treatment failure, such as persistent or recrudescent fever 36 hours after the IVIG infusion is complete, and report this promptly as it indicates IVIG resistance and a higher risk for coronary aneurysms.

How to Approach the Question

First, identify the core of the question, which is asking for the primary, first-line treatment for a specific pediatric condition: Kawasaki disease.
This is a factual recall question based on established clinical guidelines.
Access your knowledge of pediatric pharmacology and common childhood illnesses.
Evaluate each option. IV immunoglobulin is widely known as the cornerstone of Kawasaki disease therapy.
Consider the roles of the other drugs. Cyclosporine and Methotrexate are immunosuppressants, but their primary indications are for other conditions or for refractory Kawasaki disease, making them incorrect as the 'treatment of choice'. Dapsone is irrelevant to this condition.
Confirm that IVIG is the standard of care for reducing the risk of the most severe complication, coronary artery aneurysms.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 1548-1550, 1483-1485

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 701-703