Home / Visual Diagnosis # 6 : Answers

Visual Diagnosis # 6 : Answers

 

 

Kawasaki-DiseaseKawasaki Disease is an idiopathic multisystem disease characterized by vasculitis of small & medium blood vessels, including coronary arteries. It is a self-limited vasculitis of unknown etiology that predominantly affects children younger than 5 years and is now the most common cause of acquired heart disease in children in the United States and Japan.

 

 

80% of cases in children < 4 yrs, 5% of cases in children > 10 yrs. The etiology is most likely infectious and there has been some association with a novel coronavirus suggesting a viral etiology, however no definitive causative agent has been identified.

 

 

Kawasaki Disease 4 - 60secondem

About 90% of patients will have fever, conjunctival erythema, and oral mucosal changes and 70% will have lymphadenopathy. Other common symptoms include strawberry tongue and lip fissures, anterior uveitis, perianal erythema, hepatic, renal, and GI dysfunction, myocarditis, pericarditis and lymphadenopathy.

 

 

Kawasaki Disease 2 - 60secondem

 

 

 

 

 

 

 

 

 
In the acute phase, the most common blood laboratory findings include: a leukocytosis with left shift, mild anemia, an increased erythrocyte sedimentation rate or C-reactive protein, hypoalbuminemia, elevation of liver transaminases.

 

Kawasaki Disease 3 - 60secondem
Imaging: Echocardiography is used to rule out coronary artery aneurysms and myocarditis, valvulitis, or pericardial effusion. Diffuse dilatation of coronary lumina can be observed in 50% of patients by the 10th day of illness. Echocardiography should be repeated in the second or third week of illness and 1 month after all other laboratory results have normalized.
Treatment includes a one-time dose of IVIG and high-dose aspirin. Although it has a good prognosis with treatment, Kawasaki disease can lead to death from coronary artery aneurysm in a small percentage of patients.

 

 

 

 

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