Armando Hasudungan
Biology and Medicine videos

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
  • Non-thrombocytopaenia
    • Vasculitis
      • Henoch Schonlein pupura
      • Wegener’s granulomatosis
    • Hand, foot and mouth disease (Coxsackie virus)
    • Meningococcemia

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