Kawasaki Disease

Question 1

What is Kawasaki Disease?

Answer 1

• An acute febrile mucocutaneous lymph node syndrome mainly affecting infants and young children.
• Commonest vasculitis disorder
• Leading cause of acquired heart disease in children
• The basic lesion is a necrotizing vasculitis of medium-shaped muscular arteries (especially coronaries) which may result in aneurysms, dilatations and stenosis

Question 2

What are the diagnostic criterias for Kawasaki Disease?

Answer 2

• Fever lasting at least for 5 days - high grade
• Presence of any 4 of the following 5 conditions:
  a) bilateral non-purulent conjunctival injection (w/o discharge)
  b) changes of mucosa oropharynx (eg: injected pharynx, injected lips, strawberry tongue)
  c) changes of the peripheral extremeties:
• acute stage: edema, erythema of hands and foot
• convalescent stage: desquamation, which usually begins periungually
• polymorphous rash
• cervical lymphadenopathy (at least 1 node >= 1.5 cm; usually unilateral)
• clinical features evolve sequentially over a period of days and all need not be present together

Question 3

What are the signs of kawasaki disease?

Answer 3

• Thrombocytosis with periungual (around the nail) peeling = characteristic of 2nd week of illness
• Beau lines = seen during convalescent phase

Question 4

What are the complications of kawasaki disease?

Answer 4

• Arthritis
• Hydrops of gall bladder
• Sterile pyuria
• UTI

Question 5

What is the Tx for Kawasaki Disease?

Answer 5

• Single dose of IV immunoglobulin (2g/kg) & Aspirin in anti-inflammatory doses (30-50 mg/kg) until the child becomes afebrile
• Low dose aspirin (3-5 mg/kg/day) is then continued for 4-6 weeks for its antiplatelet activity