1. Why should I use gammaglobulin? The most serious problem of Kawasaki disease is the occurrence of coronary complications, which is directly related to the future prognosis of the child. High-dose gammaglobulin shock therapy has been shown to have a definite effect in preventing coronary complications. Studies have confirmed that early treatment with high-dose aspirin and gammaglobulin shock therapy can reduce the incidence of coronary aneurysm from 15% to 20% to 5% compared to aspirin alone. 2.When is the best time to infuse gammaglobulin? How to calculate the infusion dose? The earlier the high-dose gammaglobulin shock treatment is given, the better the effect. The best effect is to prevent coronary complications when used within 10 days of onset of disease. Once a coronary aneurysm has formed, aspirin and gammaglobulin are largely ineffective. Therefore, if Kawasaki disease is clinically confirmed or highly suspected, gammaglobulin should be started as soon as possible, provided there are no specific contraindications. The use of gammaglobulin is also beneficial in reducing coronary complications if an inflammatory response is still present 10 days after the onset of the disease, such as fever, rash, and elevated inflammatory markers. The dose of gammaglobulin shock therapy is 2 g per kilogram of body weight and is infused over 8 to 12 hours. If the child is combined with severe cardiac insufficiency, the infusion rate may be slowed down appropriately or a diuretic may be added to help reduce the volume load on the heart. 3. How should children who are not sensitive to gammaglobulin be treated? Will the use of hormones promote coronary artery aneurysm production? According to statistics, about 15% of children with Kawasaki disease have poor or no response to gammaglobulin shock therapy, i.e., they still have fever 48 hours after gammaglobulin infusion, or their body temperature normalizes and then rises again, or they still have a significant inflammatory response. The incidence of coronary artery aneurysm is relatively high in this group of children, so it is recommended to repeat gammaglobulin shock therapy with the same dose and manner of infusion as before. Those with subsequent fever may even be treated with a third dose of gammaglobulin. Those who do not respond to gammaglobulin therapy can be treated with hormones as a remedial treatment, such as intravenous methylprednisolone 30 mg/kg shock therapy 2-3 times or oral prednisone 2 mg/kg/day for 2 weeks. Hormones help to rapidly lower the body temperature, reduce the inflammatory response and shorten the length of hospital stay. There is no evidence that hormones can increase or promote coronary aneurysm formation. Adverse effects associated with the use of hormones need to be noted.