Kawasaki Disease
Kawasaki Disease: Acute medium-vessel vasculitis of childhood that especially affects the coronary arteries. It is an important cause of acquired heart disease in children.
Age Group
- Usually affects children under 5 years
- Most common between 1–5 years
- Can rarely occur in infants, older children, and adults
Etiology
- Exact cause is unknown
- Thought to be an abnormal immune response in a genetically susceptible child, possibly triggered by infection
Clinical Features
- Fever for ≥ 5 days is essential
- Bilateral nonpurulent conjunctivitis
- Oral changes: red cracked lips, strawberry tongue, erythematous oral mucosa
- Polymorphous rash
- Erythema/edema of hands and feet, followed later by desquamation of fingers and toes
- Cervical lymphadenopathy usually unilateral
Diagnosis
- Mainly a clinical diagnosis
- Classic diagnosis: fever for at least 5 days + at least 4 of the 5 principal features
- Echocardiography is done once Kawasaki disease is suspected to assess coronary involvement
Important Complication
- Coronary artery aneurysm is the most feared complication
- Can lead to thrombosis, myocardial infarction, or sudden death if untreated
Laboratory Findings
- Elevated ESR/CRP
- Leukocytosis may be present
- Thrombocytosis often appears in the subacute phase
Management
- IVIG is the main treatment
- Aspirin is given along with IVIG
- Early treatment reduces the risk of coronary artery complications
- Hospital admission and cardiac monitoring are important
High-Yield Points
- Child < 5 years + prolonged fever + conjunctivitis + strawberry tongue + rash + hand/foot changes = think Kawasaki disease
- Major danger = coronary artery aneurysm
- IVIG + aspirin = standard treatment
