Kawasaki disease Flashcards
What is Kawasaki disease?
A medium vessel vasculitis primarily affecting children aged 1-5, especially of Asian descent.
What type of blood vessels does Kawasaki disease affect?
Medium-sized arteries, particularly the coronary arteries, leading to a risk of coronary artery aneurysms.
What is the primary demographic affected by Kawasaki disease?
Children aged 1-5, especially Asian children, but it can occur in other ethnic groups as well.
What is the hallmark diagnostic feature of Kawasaki disease?
Fever for at least 5 days, plus 4 out of 5 clinical criteria with no other possible underlying etiology.
What are the five clinical criteria for Kawasaki disease?
Fever for more than five days along with four of the following: 1. Bilateral non-exudative conjunctivitis, 2. Mucositis (strawberry tongue, cracked lips, or erythema of the oral mucosa), 3. Polymorphous rash, 4. Extremity changes (swelling, erythema, desquamation of the palms and soles), 5. Cervical lymphadenopathy (>1.5 cm).
What is a unique feature of Kawasaki disease in terms of rash?
It is polymorphous (non-vesicular) and can appear on the trunk and extremities.
How is Kawasaki disease diagnosed?
It is a clinical diagnosis based on fever for ≥5 days and ≥4 clinical criteria, with no alternative explanation.
What laboratory abnormalities are commonly seen in Kawasaki disease?
Leukocytosis, thrombocytosis, elevated ESR and CRP, normocytic anemia, and sterile pyuria.
Why is an echocardiogram performed in Kawasaki disease?
To assess for coronary artery aneurysms, which can develop due to vasculitis.
How frequently should echocardiograms be performed in Kawasaki disease?
1) At the time of diagnosis.
2) At 2 weeks post-diagnosis.
3) At 6 weeks post-diagnosis.
What is the most serious complication of Kawasaki disease?
Coronary artery aneurysms, which can thrombose and rupture, leading to myocardial infarction.
What are other possible cardiac complications of Kawasaki disease?
Myocarditis, pericarditis, valvular regurgitation, and arrhythmias.
What is the first-line treatment for Kawasaki disease?
High-dose aspirin and IV immunoglobulin (IVIG).
What is the purpose of IVIG in Kawasaki disease?
To reduce systemic inflammation and lower the risk of coronary artery aneurysms.
Why is aspirin given in Kawasaki disease?
Aspirin reduces inflammation and prevents thrombosis in coronary artery aneurysms.
When is low-dose aspirin continued after the acute phase of Kawasaki disease?
After initial high-dose therapy, low-dose aspirin is continued for 6-8 weeks if no coronary artery abnormalities are present.
Why should children recovering from Kawasaki disease avoid live vaccines?
IVIG can interfere with the immune response, so live vaccines (MMR, varicella) should be delayed for 11 months after IVIG administration.
What are the key USMLE high-yield points for Kawasaki disease?
- Medium vessel vasculitis affecting coronary arteries.
- Occurs in children aged 1-5, especially Asian descent.
- Fever for ≥5 days plus ≥4 clinical criteria. 4. Risk of coronary artery aneurysms.
- Treated with IVIG and high-dose aspirin.
- Requires echocardiograms for monitoring.
What disease can mimic Kawasaki disease but presents with fever and rash?
Scarlet fever, but it has exudative pharyngitis and a sandpaper-like rash, whereas Kawasaki has non-exudative conjunctivitis and mucositis.
