We analyzed plasma levels of 14 cytokines in patients with Kawasaki disease (KD) before intravenous infusion of immunoglobulin (WIG) therapy using multiplex bead assay system. The results demonstrated that both inflammatory(TNF-α, IL-6, IL-8, IL-17, IFN-γ, G-CSF, MCP-1 and sIL-2Rα) and anti-inflammatory(IL-10, sTNFR1 and sTNFR2) cytokine levels were simultaneously elevated in patients refractory to the initial IVIG therapy. System-level understanding of the cytokine networks would be the key to develop a new therapeutic strategy to prevent coronary artery injuries in KD.