Massive lymphadenopathy and airway obstruction in a child with Kawasaki disease: success with pulse steroid therapy.

Kawasaki disease (KD) is an acute, febrile, self-limited, multisystem vasculitis that almost exclusively affects young children. We describe a 4-year-old girl with intravenous immunoglobulin (IVIG) resistant KD who developed massive cervical lymphadenopathy and severe respiratory distress. Treatment with intravenous pulse methylprednisolone led to dramatic resolution of her symptoms. We conclude that pulse steroid therapy should be considered in patients with KD complicated by massive lymphadenopathy with life threatening airway obstruction and/or IVIG resistant disease.