[Therapy of vasculitis in children].

Therapy of vasculitis syndromes varies considerably according to different forms and gravity. Mild cases often heal spontaneously. In other cases, when the causal factors are known, the removal of the offending antigen or the treatment of an underlying primary disease are sufficient to obtain remission. In the vasculitis syndromes, in which the causal factors are unknown, therapy is based on various associations of nonsteroidal antiinflammatory drugs, antiplatelet drugs, anticoagulants, corticosteroids and cytotoxic drugs, depending on the type, extention and gravity of disease. In most severe systemic necrotizing vasculitis, therapy with corticosteroids and cytotoxic drugs must be protracted for months, with inevitable side-effects, particularly severe in children. Pulse therapy with intravenous bolus of high doses of methylprednisolone seems to offer a new valid therapeutic approach, but is still under investigation. Plasmapheresis may be successful in acute and grave forms. High dose intravenous gammaglobulin therapy is indicated in the prevention of coronary involvement of Kawasaki disease. In this review these problems and therapeutic regimes suggested by different Authors are discussed, with particular attention to their application in childhood.