Kawasaki Disease

Question 1

What is Kawasaki disease ?

Answer 1

• Is an idiopathic acute, systemic vasculitis that mainly affects children under the age of 5yo

Question 2

Symptoms?

Answer 2

• Fever (lasts for at least 5days)
• A rash on the stomach, chest and genitals
• Swollen tongue with a white coating
• Strawberry tongue
• Swollen lymph nodes
• Red, dry and cracked lips
• Sore, irritated throat
• Swollen palms of hand and soles of feet with a purple-red-color

Question 3

What is the differential diagnosis?

Answer 3

• Scarlet fever
• Acute rheumatic fever
• Steves-Jhonson syndrome
• Staphylococcal scalded skin syndrome

Question 4

Workup ?

Answer 4

• CBC ( elevated platelet )
• BMP ( 8 different substances)
• CRP
• ESR
• ECG
• Urine analysis
• Echocardiogram (a must)
• Rapid streptococcal antigen test

Question 5

Effects of Kawasaki disease on the heart ?

Answer 5

• Coronary artery aneurysm (CAA)
• Pericarditis
• Tachycardia
• Decreased ventricular function

Question 6

Management?

Answer 6

• IVIG (antibody, that can fight viruses, bacteria, fungal…) and high dose of Aspirin

Question 7

Treatment?

Answer 7

• IVIG = 2g/kg, one-time dose
• Aspirin high dose (30-50mg/kg/day)
• Once fever is under control, we give low dose of aspirin
• Steroids are rarely needed
• Follow ESR&CRP until it normalizes
• Follow up echocardiogram at 1-2 weeks and 6-8 weeks