Third-line therapies in patients with Kawasaki disease refractory to first- and second-line intravenous immunoglobulin therapy

Kawasaki disease(KD)is an acute febrile illness character-ized by systemic vasculitis affecting the small-and medium-sized arteries in children[1,2].One of the most critical complications of KD is the development of coronary artery lesions(CALs)approximately after 12 days of illness,which may lead to myocardial infarction[3].High-dose intravenous immunoglobulin(IVIG)and oral administration of aspirin have been established as the first-line therapy for KD[4,5].