Kawasaki Disease

Question 1

Define Kawasaki disease

Answer 1

Kawasaki disease is an acute, self-limiting systemic vasculitis of unknown cause that mainly affects children under 5 years old. It causes inflammation of medium-sized arteries throughout the body, with a particular tendency to affect the coronary arteries, making it the leading cause of acquired heart disease in children in developed countries

Question 2

Kawasaki Hallmark Sx

Answer 2

1. high fever lasting at least five days
2. a widespread rash
3. swollen lymph nodes in the neck
4. conjunctivitis without discharge
5. red and cracked lips
6. swollen “strawberry” tongue

Question 3

what size arteries do Kawasaki affects?

Answer 3

Medium-size arteries - coronary arteries

Question 4

Kawasaki complications

Answer 4

1. Aneurysm Formation: Ongoing inflammation weakens the vessel wall, resulting in aneurysm formation, particularly in the coronary arteries
2. Thrombosis and Stenosis: Pro-inflammatory mediators promote thrombosis and myofibroblastic proliferation, leading to arterial stenosis and potential occlusion
3. Fibrosis: Over weeks to months, inflammation is replaced by fibroblast proliferation and intimal thickening, which can cause long-term vascular narrowing or occlusion

Answer 5

1. Trigger - Unknown antigen in genetically susceptible child
2. Immune activation - Innate and adaptive (T cells, B cells, cytokines, ICs)
3. Vessel involvement - Medium-sized arteries (esp. coronary), can affect others
4. Early cellular infiltrate - Neutrophils (acute), followed by monocytes, lymphocytes
5. Vessel wall damage - Necrotizing arteritis, aneurysm, thrombosis, stenosis
6. Chronic changes - Fibrosis, intimal thickening, risk of long-term sequelae

Question 6

Kawasaki Management

Answer 6

1st line:
Intravenous immunoglobulin (IVIG) and high-dose aspirin, ideally within 10 days of symptom onset

Supportive care Monitor for complications, manage fever and hydration

Cardiology follow-up Serial echocardiograms to monitor coronary arteries

Question 7

What Ix is essential in all suspected Kawasaki cases?

Answer 7

Echo to assess cardiac function / structural abnormalities

Question 8

Kawasaki most common affected age group

Answer 8

< 5 years

Question 9

What is the major complication of Kawasaki

Answer 9

Conronary artery aneurysms