Kawasaki's disease Flashcards
What is kawasaki’s disease?
Vasculitis which inflames the small to medium arteries causing aneurysms to form
What age group does Kawasaki’s Disease?
6 months to 4 years olf
What are the diagnostic criteria for kawasaki’s disease?
Fever for >/=5 days, + at least 4 of the following
- Conjunctivitis - Bilateral non-purulent
- Rash - Polymorphous
- Edema/Extremities - arthralgia, palmar erythema, finger desquamation + swelling fo hands and feet
- Adenopathy - cervical, often unilateral
- Mucosal involvement - Pharyngeal injection, dry fissured lips, strawbeery tongue
Can be diagnosed with Kawasaki’s if <4 + coronary artery aneurysm
What occurs in the acute phase of Kawasaki’s Disease?
Lasts 1-2 weeks
- Fever + Major signs as per criteria
- Diarrhoea
- Can have jaundice
What are features of the subacute phase of Kawasaki’s disease?
Lasts approximately 2 weeks
- Coronary arteritis +/- infarction
- Cardiovascular signs - gallop, myocarditis, pericarditis, sudden death
How long is the convalescent phase of Kawasaki’s disease?
Approximately 7 weeks
How long does a fever have to be present for for the diagnosis of Kawasaki’s Disease (based on the diagnostic criteria)?
>/= 5 days
How would you investigate a child with suspected KAwasaki’s Disease?
-
Bedside
- Monitoring - none
- Tests - Urinalysis
- Orifices - None
- Bloods - CRP, ESR, LFTs, FBC, a2-globulin
What might you see on LFT in someone with Kawasaki’s Disease?
- Increased Bilirubin
- Increased AST
What might you see on FBC in someone with Kawasaki’s Disease?
Thrombophilia
What might you consider as a differential diagnosis for someone presenting with features of Kawasaki’s Disease?
- SJS
- Measles
- Strep
- EBV
How would you treat kawasaki’s Disease?
- Aspirin
- IV immunoglobulins
How would you follow up someone with Kawasaki’s disease?
- ECHO
- Coronary MR angiography - defines aneurysms
