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Kawasaki Disease
Overview
Overview Kawasaki Disease is a uncommon systemic vasculitis disease affecting mainly children under the age of 5.
Signs and Symptoms
- <5 years old
- Irritable
- High Fever >5 days
- Conjuctivitis (bilateral non purulent)
- Rash
- polymorphous
- Maculopapular
- Erythema and oedema of hands or feet
- Adenopathy
- Mucous membranes
- Dry cracked lips
- Red tongue
- Strawberry tongue
Differential Diagnosis
Differential Diagnosis of Purpura/Petechiae in a child
- Thrombocytopaenia
- Decreased platelet production
- Infections
- Drugs and alcohol
- Aplastic anaemia
- Leukaemia
- Myelodysplastic syndrome
- Increased platelet destruction
- Immune mediated - Immune thrombocytopaenic purpuura
- Non-immune mediated - causes of microangiopathic haemolysis (TTC, HUS, DIC, pre-eclampsia, HELLP)
- Dilutional thrombocytopaenia - from massive blood transfusion
- Distributional thrombocytopaenia - caused by splenic sequestration
- Portal hypertension
- Decreased platelet production
- Non-thrombocytopaenia
- Vasculitis
- Henoch Schonlein pupura
- Wegener’s granulomatosis
- Hand, foot and mouth disease (Coxsackie virus)
- Meningococcemia
- Vasculitis
Investigations
- Anti-streptolysin O test
- Anti DNAase B
- LFT
- FBC
- Echocardiogram
| Remember Main complication of Kawasaki disease is coronary artery aneursym |
Pathophysiology
To come...
Management
- Paediatric consult
- Admit to hospital
- Immunoglobulin IV (~10days)
- Aspirin
| Side note Aspirin is not usually used for children because of the risk of Reye Syndrome (Encephalopathy + liver damage). Kawasaki is an exception |
Ongoing management
- Education - Kawasaki is not contagious
- Follow-up with doctor for complication
Complications and Prognosis
Complications
- Coronary artery aneurysm
- As well as artery aneurysm anywhere else
- Myocardial infarction
- Pericarditis
- Myositis
Summary
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