Vasculitis

Question 1

Kawasaki’s disease

Answer 1

2nd most common vasculitis of childhood
Most common cause of acquired heart disease in childhood
Fever for 5 days plus 4/5 eyes/mouth/cx ln/ rash not vesicular/ extremities
Treatment IVIG /aspirin/ echo no live vaccination 6-12/12
80% <5years but can occur babies and >7
Males&raquo_space; females
30% of kids don’t have 4/5 subtle /missed
25% will have complications without treatment
5% with treatment within 10 days of fever
90% of the coronary a Aneurysm regression

Question 2

HSP

Answer 2

Commonest vasculitis of childhood 
Rash purpura/ scrotum/scalp/Petiche LL
GIT angina gut pain after a meal  can mimic intussception Pr bleeding and acute morbitidy
Arthritis 
Acute scrotum
Kidney BP and haematuria 
Chronic morbidity <5% get CKD

Question 3

Dd HSP

Answer 3

Acute abdo
Acute scrotum
rash can look like meningococcal
Other vasculitis

Question 4

Diagnostic criteria

Answer 4

Purpura
Age <20
Granulocytosis
Bowel angina pain after eating or PR bleeding and abdo pain

Question 5

SLE juvenile

Answer 5

20% of all SLE starts <18years
11-14 years is the peak time
Autoimmune disease ( Immunoglobulin deposits )+/- vasculitis
Oral ulcers vascular painless
Raynauds
Polyarthritis
Nephritis mild -severe biopsy is often needed to guide treatment