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Nighttime view of Temple University Children's Hospital Temple University Hospital in background, Kresge Hall (left) and Medical Research Building (right) in foreground Old Medical School building in foreground, Jones Hall, General Services building and Student Faculty Center to the right

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

Stephen Aronoff, MDWhen 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,” said Stephen Aronoff, a Professor in the School of Medicine and Chair of Pediatrics, who is the lead author of the meta-analysis. “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 IVIG, reduced the odds of developing inflammation of the heart blood vessels by half.”

 

Aronoff hopes that a multi-center study, currently under way, 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 five days; skin rash; red eyes, palms and foot soles; and swollen lymph nodes. If not treated within five to 10 days, it can lead to serious, sometimes life-threatening, complications. Fortunately, Kawasaki’s is treatable, and most children recover fully.

 

This study was spearheaded by former Temple medical student Angela Wooditch, who collaborated with Aronoff on the analysis. Wooditch is currently performing her residency with a preliminary year at Abington Memorial Hospital and then her anesthesia residency next year at the University of Pittsburgh.

 

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- By Eryn Jelesiewicz

October 20, 2005