Pulse methylprednisolone therapy for impending cardiac tamponade in immunoglobulin-resistant Kawasaki disease

We describe a boy with Kawasaki disease (KD) whose clinical course was mark ed by a rapid improvement upon treatment with intravenous immunoglobulin (I VIG) and oral aspirin, which within 14 days - was followed by the developme nt of a large pericardial effusion with symptoms of impending cardiac tampo nade as part of a polyserositis syndrome (pleural effusions, ascites). Upon treatment with pulsed methylprednisolone, the pericardial and pleural effu sions and ascites rapidly disappeared within 48 h. This is the first case r eported with a polyserositis syndrome and impending cardiac tamponade durin g KD.