Kawasaki Disease

Kawasaki Disease

MM Carr DDS MD MEd

What is it?

Kawasaki Disease is a multi-system vasculitis of unknown etiology (putatively viral) which is more common in children under the age of 2.

There are specific criteria for diagnosis, three phases of the illness, known complications, and a specific treatment.

Criteria for Diagnosis

5 of the following 6 criteria are required for a diagnosis:

• Fever persisting 5 or more days
• Peripheral extremity changes:
  • Initially: reddening of palms and soles
  • Convalescent stage: membranous desquamation from fingertips
• Polymorphous exanthem
• Bilateral conjunctival congestion
• Changes of lips and oral cavity: reddening of lips, strawberry tongue, diffuse erythema of oropharyngeal mucosa
• Acute nonpurulent cervical lymphadenopathy

Complications of Kawasaki Disease

• Coronary artery aneurysms
• Corononary artery thrombosis
• Myocardial infarction
• Myopericarditis
• Congestive heart failure
• Aseptic meningitis
• Uveitis
• Arthritis
• Thrombocytosis
• Uveitis
• Urethritis

Phases of the Disease

• Acute Phase: Lasts 10 days, during which most of the diagnostic criteria are present. Irritability, aseptic meningitis, myocarditis, and pericarditis may also occur.
• Subacute Phase: From days 11 to 21, during which fever resolves. Skin desquamation appears about day 14. Arthritis may occur during this phase.
• Convalescent Phase: Acute phase reactants subside. Coronary artery aneurysms may be detected or rupture at this point.

Treatment

High doses of aspirin are used in the acute phase, followed by low doses of aspirin until the end of the convalescent phase. Immunoglobulin therapy during the acute phase may also be used.