Osmosis: Kawasaki Disease

Question 1

what is kawasaki disease?

Answer 1

vasculitis of medium sized vessels

mostly effects coronary arteries but an effect any large of medium sized arteries

when the endothelial cells are attacked, they get damaged which exposes underlying collagen and TF in the tunica media which leads to increased change of blood coagulation = clots that can block blood flow in the coronary arteries and ischemia of the heart

damaged endothelial cells in the coronary arteries = weak walls = coronary aneurysms because fibrin is deposited in the vessel walls as part of the healing process which makes arteries less elastic and the vessels have permanent bulges – if there isn’t an aneurysm, the vessel wall is thicker which reduces lumen diameter which reduces blood flow = heart ischemia

Question 2

who gets kawasaki disease?

Answer 2

kids under 5 years old

boys > girls

inflammation which resolve in 6-8 weeks but if untreated, 25% of heart complications like ischemia

Question 3

what are the symptoms of kawasaki disease?

Answer 3

1. conjunctivitis with limbus sparing (around the iris is white)
2. rash on all the body parts but eventually flakes off
3. adenopathy = cerivcal lymph node enlargement
4. strawberry tongue
5. dry lips
6. swollen hands and feet
7. 5+ days of fever that doesn’t resolve with NSAIDS

Question 4

what are the lab results seen with Kawasaki disease?

Answer 4

1. anemia
2. leukocytosis with left shift
3. increased CRP
4. increased ESR
5. increased liver enzymes
6. mononuclear WBC in the urine without bacteria
7. platelet count increases after a few weeks
8. echo to look at coronary arteries

so you diagnose via tests and symptoms

Question 5

how do you diagnose kawasaki disease?

Answer 5

Crash and burn!!!

Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Hand/feet issues

plus a fever for more than 5 days

this is how you diagnose Kawasaki!

Question 6

how do you treat kawasaki disease?

Answer 6

IVIG = antibody from other individuals that is thought to calm down the immune system and reduce inflammation

ASA = acetylsalicylic acid = aspirin which inhibits COX and prevents platelets from aggregating together –> shouldn’t give aspirin to kids because they could get Reye syndrome but the risk of kawasaki is worse

Reye syndrome = encephalopathy and liver injury