CVS - Kawasaki Disease

Question 1

What is Kawasaki Disease?

Answer 1

A Mucocutaneous Lymph Node Syndrome; a systemic medium-sized vessel vasculitis.

Question 2

Epidemiology of Kawasaki Disease (3).

Answer 2

1. Typically affects young children, under the age of 5.
2. Commoner in Asians (Korean, Japanese).
3. Commoner in boys.

Question 3

Aetiology of Kawasaki Disease.

Answer 3

No clear cause or trigger.

Question 4

Clinical Features of Kawasaki Disease (7).

Answer 4

1. Persistent High Fever (39 Degrees) for 5+ Days.
2. Widespread Erythematous Maculopapular Rash.
3. Desquamation (Skin Peeling on Palms/Soles).
4. Strawberry Tongue (Red Tongue with Large Papillae).
5. Cracked Lips.
6. Cervical Lymphadenopathy.
7. Bilateral Conjunctivitis.

Question 5

Clinical Features of Kawasaki Disease (5) MNEMONIC.

Answer 5

CREAM : Conjunctivitis, Rash, Edema/Erythema of Hands/Feet, Adenopathy (Unilateral Cervical), Mucosal Involvement e.g. Strawberry Tongue, Oral Fissures).

Question 6

Phases of Kawasaki Disease (3).

Answer 6

1. Acute - Unwell, Fever, Rash, Lymphadenopathy (1-2 weeks).
2. Subacute - Desquamation and arthralgia with risk of coronary artery aneurysm formation (2-4 weeks).
3. Convalescent - remaining symptoms settle and blood tests slowly return to normal (2-4 weeks).

Question 7

Investigations of Kawasaki Disease (6).

Answer 7

1. FBC - Anaemia, Leukocytosis, Thrombocytosis.
2. LFTs - Hypoalbuminaemia, Elevated Liver Enzymes.
3. Inflammatory Markers - especially ESR.
4. Urinalysis - Raised WCC without Infection.
5. Echocardiogram - Coronary Artery Pathology.
6. Clinical diagnosis (no specific test).

Question 8

Management of Kawasaki Disease (3).

Answer 8

1. High-Dose Aspirin (reduce risk of thrombosis).
2. IV Immunoglobulins (reduce risk of coronary artery aneurysms).
3. Close follow-up with echocardiograms to monitor for evidence of coronary artery aneurysms.

Question 9

Importance of Aspirin (2).

Answer 9

1. One of the very few indications of Aspirin in kids due to risk of Reye’s syndrome.
2. Contraindication for Influenza Vaccination.