Kawasaki's Disease

Question 1

What is Kawasaki’s Disease?

Answer 1

Kawasaki’s disease is a acute vasculitis of unknown aetiology which is likely triggered by infection. It is a medium sized vasculitis which has a predilection for coronary arteries. Always consider Kawasaki’s Disease in a persisting fever after excluding other possible options.

Question 2

Describe the diagnostic criteria/clinical presentation for Kawasaki’s disease.

Answer 2

Warm CREAM
Warm - Fever persisting 5d or more
AND four of the following:
C - bilateral Conjuntival injections
R - polymorphous Rash
E - changes of the peripheral Extremities. acute phase: peripheral Edema, peripheral Erythema
A - cervical lymphAdenopathy
M - Mucosal involvement (red infected fissured lips, strawberry tongue, injected pharynx)

Question 3

What is the management of Kawasaki’s Disease?

Answer 3

• high dose of aspirin while febrile
• low dose of aspirin in subacute phase until platelets normalise or if coronary artery involvement
• IVIG reduces risk of coronoary artery involvement
• Echo to determine coronoary artery involvement

Question 4

Who gets Kawasaki’s Disease?

Answer 4

It is the most common cause of acquired heart disease in children in developed countries. Peak age: 3mo - 5yrs
Asians>Blacks>Caucasians