KAWASAKI'S DISEASE Flashcards
Other names for KD
KAWASAKI’S SYNDROME
MUCOCUTANEOUS LYMPH NODE SYNDROME
Most common occurrence of KD?
Children<5yrs
Male>female
What is KD
Etiology of KD
No Known etiology but associated with;
1) GENETICS
- Predisposed if a parent or a sibling has it
2) INFECTION
Human Adenovirus
Mycoplasma pneumoniae
Epstein Barr Virus
3) AUTOIMMUNE REACTION
Pathophysiolgy of KD
Vasculitis especially of coronary arteries
PHASES OF KD
1) ACUTE PHASE
2) SUBACUTE PHASE
3) EARLY CONVALESCENT PHASE
4) LATE CONVALESCENT PHASE
Features of Acute phase KD
• 1-2wks history
• Small vessel vasculitis
• Pancarditis
• Erythema & swelling of palms & soles
• Major Death causes: HF, Arrhythmias
Features of Subacute phase KD
• 3-4wks history
• Midsize muscular arteries vasculitis
• Coronary artery aneurysm
• Coronary artery thrombosis
• Periungual Desquamation of fingers & toes
• Major Death Causes: MI, Coronary artery aneurysm rupture
Features of Early Convalescent phase KD
• 4-7wks history
• Decreased Inflammation
• Intimal Proliferation
• Granulomas
• Beau Groove
• Major Death Cause: MI
Features of Late Convalescent phase KD
• >7wks history
• Fibrotic scar formation
• Stenotic Occlusion of vessels
• Coronary recanalization
• Beau Groove
• Major Death cause: MI
Main Clinical manifestations of KD
1) FEVER>39°C
High spiking & remittent
Unresponsive to antibiotics
2) CONJUNCTIVITIS
- Bilateral without exudate
3) POLYMORPHOUS RASH
- Erythema multiforme
- Desquamation in perineal & perianal region
4) CERVICAL LYMPH NODE ENLARGEMENT
Acute, unilateral & non-suppurative
Diameter>1.5cm
5) DIFFUSE ERYTHEMA OF OROPHARYNGEAL MUCOSA
- Strawberry tongue
- Red, cracked, fissuring, peeling & bleeding lios
Other Clinical manifestations of KD
1) CARDIOVASCULAR
2) RESPIRATORY
3) GASTROINTESTINAL
4) UROGENITAL
Cardiovascular Clinical manifestations of KD
Carditis
Heart Failure
Coronary aneurysm
Coronary thrombosis
Vulvar regurgitation
Aortic root enlargement
Shock
Peripheral aneurysm
Peripheral gangrene
Respiratory Clinical manifestations of KD
Cough
Pneumonia
Pulmonary nodules
Sniveling
GI Clinical manifestations of KD
Abdominal pain
Vomiting
Diarrhea
Hepatitis with jaundice
Pancreatitis
Intestinal obstruction
Gallbladder Hydrops
Genitourinary Clinical manifestations of KD
Urethritis
Hydrocele
Neurologic Clinical manifestations of KD
Extreme irritability
Behavioral changes
Aseptic meningitis
Peripheral facial nerve palsy
Sensorineural hearing loss
DIAGNOSIS OF KD
1) BLOOD TEST
Elevated WBC
Elevated platelets
Elevated ESR & C reactive protein
Elevated cardiac enzymes (CK & BNP)
Elevated Bilirubin, AST, ALT
Decreased Albumin
2) ECHO
For aneurysm & rule out coronary artery lesions (CAL)
3) CORONARY ARTERIOGRAPHY
4) ECG
Types of KD
COMPLETE KD
INCOMPLETE KD
TREATMENT OF KD
1) ASPIRIN
2) IMMUNOGLOBULINS
