Kawasaki Disease Flashcards
What is Kawasaki disease?
Kawasaki disease or Kawasaki syndrome is a rare type of vasculitis (blood vessel inflammation).
Inflamed blood vessels can become weak and stretched out. When that happens, they’re at risk of tearing or narrowing. This limits how much blood can get through to nourish tissues and organs.
Kawasaki disease happens most often in children 6 months to 5 years of age. It affects all of their arteries, but the biggest concern is the coronary arteries. These supply blood to your heart.
Diagnosis of Kawasaki disease
- Persistent fever: The child must have a high fever that lasts for at least five days, and it does not respond to typical fever-reducing medications.
- Other clinical criteria: The child must have at least four of the following five clinical features:
• Redness and swelling of the hands and feet (often with peeling of the skin)
• Rash, usually on the trunk and in the genital area
• Bilateral conjunctival injection (redness of the eyes without discharge)
• Changes to the lips and oral cavity, such as redness, dryness, and cracking of the lips, strawberry tongue (a red, bumpy tongue), and redness of the throat
• Swollen lymph nodes in the neck (at least one lymph node should be larger than 1.5 cm in diameter)
- Exclusion of other diseases: The healthcare provider will consider and exclude other possible causes of the symptoms, such as infections or allergic
- Investigations :-
When investigating Kawasaki disease, healthcare professionals may conduct various tests and examinations to aid in diagnosis and assess the extent of the disease. Here are some common investigations and their interpretation in Kawasaki disease:
- Blood tests: Blood tests are commonly performed to assess inflammation levels and identify any other abnormalities. The following results may be observed:
- Elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR): These are markers of inflammation and are often elevated in Kawasaki disease.
- Elevated white blood cell count: An increased number of white blood cells, particularly neutrophils, can be seen in the acute phase of the disease.
- Anemia: Reduced red blood cell count or hemoglobin levels may be observed.
- Platelet count: Thrombocytosis, which is an elevated platelet count,
- Echocardiogram: An echocardiogram is an ultrasound examination of the heart that assesses the structure and function of the heart, including the coronary arteries. The following findings may be observed:
- Coronary artery abnormalities: Inflammation of the coronary arteries can be detected, including dilation (enlargement) or the presence of aneurysms (balloon-like bulges) in the coronary arteries. The severity and extent of coronary artery involvement can be assessed.
- Electrocardiogram (ECG): An ECG records the electrical activity of the heart. In Kawasaki disease, it may reveal:
- Arrhythmias: Irregular heart rhythms may be observed in some cases.
- Other cardiac abnormalities: ECG changes, such as ST segment and T-wave abnormalities, can indicate myocardial involvement.
- Urinalysis: Urine analysis may be conducted to assess kidney function. In Kawasaki disease, it may reveal:
- Proteinuria: The presence of protein in the urine may indicate kidney involvement.
- Imaging studies: In some cases, additional imaging studies such as chest X-rays may be performed to evaluate the heart and lungs, looking for signs of inflammation or other abnormalities.
It’s important to note that the interpretation of these investigations should be done by a healthcare professional with experience in diagnosing and managing Kawasaki disease. The results of these tests, along with the clinical presentation and other factors, will help guide the diagnosis and treatment plan for Kawasaki disease. If you have specific test results that you would like to discuss or need further clarification, it is best to consult with a healthcare professional for appropriate interpretation and guidance.
stages of Kawasaki disease
What are the three stages of Kawasaki disease?
The three stages of Kawasaki disease are:
Stage 1 (Acute)
Fever for five days or more.
Rash around the trunk or groin.
Pink eye.
Red tongue and lips.
Red skin on hands and feet (palms and soles).
Swelling in lymph nodes.
Stage 2 (Subacute)
Starts when fever goes away.
Upset stomach.
Diarrhea.
Pain in joints and belly.
Peeling skin on hands and feet.
Stage 3 (Convalescent)
Symptoms go away slowly, but complications can continue.
complications of Kawasaki disease?
- Aneurysms (weakness or stretching) in inflamed coronary arteries. In severe cases, this may require coronary artery bypass surgery.
- Blood clots and narrowing in coronary arteries.
- Coronary artery rupture.
- Issues with the heart valves that help blood move the right direction through your child’s heart.
-Inflammation in your child’s heart.
- Hepatitis in your child’s liver.
- Inflammation in your child’s lungs.
- Infections in your child’s heart.
- Pancreatitis (inflammation) in your child’s pancreas.
- Poor heart function or heart failure.
Heart attack.
Management
- Intravenous Immunoglobulin (IVIG): IVIG is a solution containing concentrated antibodies obtained from healthy donors. It is administered through a vein (intravenously) and helps to modulate the immune response and reduce inflammation. IVIG is typically given as a single infusion, usually at a high dose, over a period of several hours. It is most effective when given within the first 10 days of the illness, ideally within the first 7 days.
- Aspirin: High-dose aspirin therapy is often used in conjunction with IVIG. Aspirin helps to reduce inflammation, relieve fever, and prevent blood clotting.
3- Fluids by IV for hydration.
4- Medications for pain and swelling.
5- Anticoagulants (blood thinners) for people at risk of blood clots.
6- Steroids or other anti-inflammatory medications to reduce inflammation in severe cases.
7- Cold compresses.
The goals of Kawasaki disease treatment are to:
Reduce inflammation.
Prevent or lessen damage to arteries.
Prevent blood clots in people with coronary artery issues.
Prevent heart complications.
