Pre-IVIG echocardiography enables targeted treatment in infants younger than 6 months with Kawasaki Disease…

Cohort studyEuropean journal of pediatrics· Jul 2026

Pre-IVIG echocardiography enables targeted treatment in infants younger than 6 months with Kawasaki Disease : Echocardiography-based risk stratification in young infants with Kawasaki Disease.

Ming-Chun Yang, Kun-Lang Wu, Chi-Nan Huang … Taiwan Kawasaki Disease Research Network

Pediatric CardiologyCohort studyQ1IF 3.2

Infants under 6 months with Kawasaki disease have higher coronary aneurysm risk at diagnosis

Pre-IVIG echocardiography enables targeted treatment in infants younger than 6 months with Kawasaki Disease : Echocardiography-based risk stratification in young infants with Kawasaki Disease.

Ming-Chun Yang … Taiwan Kawasaki Disease Research Network

European journal of pediatrics · Jul 2026 · Q1 in Pediatrics

Background

UNLABELLED: The 2024 American Heart Association scientific statement suggests intensification therapy in infants younger than 6 months (< 6 months) with Kawasaki disease (kawasaki disease) may be beneficial, but indications remain undefined.

Purpose

We hypothesized that pre-intravenous immunoglobulin echocardiographic findings could identify infants < 6 months who do not require intensification beyond standard intravenous immunoglobulin (intravenous immunoglobulin).

Methods

Were stratified as < 6 months or ≥ 6 months.

n = 398 children

Results

coronary aneurysm nearly 3 times more likely at diagnosis under 6 months

OR 2.74 (95% CI 1.45 to 5.18)

CI excludes the null - significant

More results

Among 398 children with kawasaki disease, 44 (11.1%) were younger than 6 months.

Intravenous immunoglobulin within 7 days was associated with lower coronary artery aneurysm risk in both groups.

More results

Among children with initially normal coronary dimensions, new coronary artery aneurysm risk did not differ significantly between younger and older groups (4.8% vs 2.4%; P = .42).

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Conclusion · 1 of 4

Pre-intravenous immunoglobulin echocardiography may help identify infants < 6 months at low risk for subsequent coronary artery aneurysm development with standard intravenous immunoglobulin treatment.

Conclusion · 2 of 4

Given the observational nature of this study, larger prospective studies are warranted to confirm these findings.

Conclusion · 3 of 4

WHAT IS KNOWN: • Infants younger than 6 months with Kawasaki disease (kawasaki disease) have elevated coronary artery aneurysm (coronary artery aneurysm) risk.

Conclusion · 4 of 4

• The 2024 AHA scientific statement suggests intensification therapy may be beneficial in this age group, but clear indications remain undefined.

Pre-IVIG echocardiography enables targeted treatment in infants younger than 6 months with Kawasaki Disease : Echocardiography-based risk stratification in young infants with Kawasaki Disease.

Pre-IVIG echocardiography enables targeted treatment in infants younger than 6 months with Kawasaki Disease : Echocardiography-based risk stratification in young infants with Kawasaki Disease.

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