Kawasaki Disease

Question 1

What is Kawasaki disease?

Answer 1

-acute medium vessel vasculitis affecting children under the age of 5 years

Question 2

Which children are usually affected by Kawasaki disease?

Answer 2

1. Japanese children

2. Rare under 3 months and above 5 years

Question 3

How long do symptoms of Kawasaki disease present for?

Answer 3

2-4 weeks and then resolve

Question 4

What are the 5 clinical presentations for Kawasaki disease?

Answer 4

1. Fever for more than 5 days
2. cervical lymphadenopathy
3. Erythema or oedema of the palms and soles of the feet
4. Bilateral conjunctivitis
5. Red mouth(stawberry tongue, red fissured lips)

Question 5

What should we immediately be worried about in Kawasaki disease?

Answer 5

Coronary artery aneurysm in 20% of patients

Question 6

What is the differential diagnosis for Kawasaki disease?

Answer 6

1. Group A streptococcal infections
2. Measles
3. Drug reactions
4. Infectious mononucleosis

Question 7

What do we usually see on lab tests?

Answer 7

1. High acute phase markers-ESR and CRP
2. Neutrophil leucocytosis
3. Elevated bilirubin
4. Elevated platelet 10-14 days after infection may also be seen

Question 8

How do we treat Kawasaki disease

?

Answer 8

1. With intravenous immunoglobulin in the first 10 days of illness
   - usually 2g/kg over 10-12 hours
2. Add aspirin (30-50mg/kg/day)

Question 9

What does the aspirin do?

Answer 9

It reduces the severity and duration of symptoms but has no function on the development of the coronary artery vasculitis

Question 10

How should we treat the peeling fingers and sore lips?

Answer 10

With emollients and lip balm

Question 11

What special investigation can we do to detect the coronary artery involvement?

Answer 11

Echocardiogram