DOI: https://dx.doi.org/10.18203/2319-2003.ijbcp20222147
Published: 2022-08-24

A case report on Kawasaki disease

Muhammed Nishad P., S. Mohamed Ashik Ali S., A. Priya, K. Arun Chander

Abstract


Kawasaki disease (KD) is an acute vasculitis of children that leads to coronary artery aneurysms in ≈ 25 of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disorder in children in developed countries. The diagnosis of KD is made on basis on the clinical findings. Atypical KD includes patients who don't meet all the criteria for opinion. The main complication of Kawasaki complaint is coronary aneurysm, and the treatment is intravenous immunoglobulin and aspirin. Another dose of immunoglobulin is given if the patient doesn't ameliorate, and several other treatment options have been proposed over the last many years as alternate and third line options. The AHA criteria, which incorporate suggestions for laboratory tests and early echocardiography, are helpful for diagnosing incomplete KD. Diagnosis is based on the presence of fever lasting longer than 5 days and four of five specific clinical criteria. In Japan, at least five of six criteria (fever and five other clinical criteria) should be fulfilled for the determination of KD. From the Japanese circulation society joint working groups criteria (JCS 2008, Guidelines for diagnosis and management of cardiovascular sequela in KD), KD can be diagnosed indeed when fever lasts lesser than 5 days. Though, according to the American heart association (AHA) criteria, fever lasting more than 5 days is essential for KD diagnosis. The use of intravenous immunoglobulin is well established in KD. Aspirin has been used in KD for anti-inflammatory effect, and low-dose aspirin is recommended to reduce the risk of thrombosis.


Keywords


KD, Coronary artery aneurysm, Aspirin, Intravenous immunoglobulin

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References


Wood LE, Tulloh RM. Kawasaki disease in children. Heart. 2009;95(10):787-92.

Dajani AS, Taubert KA, Gerber MA, Shulman ST, Ferrieri P, Freed M et al. Diagnosis and therapy of Kawasaki disease in children. Circulation. 1993;87(5):1776-80.

Newburger JW, Takahashi M, Burns JC. Kawasaki disease. J Am College Cardiol. 2016;67(14):1738-49.

Oates‐Whitehead RM, Baumer JH, Haines L, Love S, Maconochie IK, Gupta A et al. Intravenous immunoglobulin for the treatment of Kawasaki disease in children. Cochrane Database of Systematic Reviews. 2003(4).

Wardle AJ, Connolly GM, Seager MJ, Tulloh RM. Corticosteroids for the treatment of Kawasaki disease in children. Cochrane database of systematic reviews. 2017(1).

Dallaire F, Fortier-Morissette Z, Blais S, Dhanrajani A, Basodan D, Renaud C et al. Aspirin dose and prevention of coronary abnormalities in Kawasaki disease. Pediatrics. 2017;139(6).

Rowley AH, ST S. Kawasaki disease. Nelson textbook of pediatrics. 2000;17:793-834.

Singh S, Jindal AK, Pilania RK. Diagnosis of Kawasaki disease. Int J Rheumatic Dis. 2018;21(1):36-44.

Kuo HC, Yang KD, Chang WC, Ger LP, Hsieh KS. Kawasaki disease: an update on diagnosis and treatment. Pediatr Neonatol. 2012;53(1):4-11.

Harnden A, Takahashi M, Burgner D. Kawasaki disease. BMJ. 2009;338.

Rowley AH, Shulman ST. Pathogenesis and management of Kawasaki disease. Expert Rev Anti-Infective Therapy. 2010;8(2):197-203.

Chen S, Dong Y, Yin Y, Krucoff MW. Intravenous immunoglobulin plus corticosteroid to prevent coronary artery abnormalities in Kawasaki disease: a meta-analysis. Heart. 2013;99(2):76-82.

Leung DY. The immunoregulatory effects of IVIG in Kawasaki disease and other autoimmune diseases. IVIG therapy today. 1992:93-104.

Freeman AF, Shulman ST. Kawasaki disease: summary of the American Heart Association guidelines. Am Family Physician. 2006;74(7):1141-8.

Uehara R, Belay ED. Epidemiology of Kawasaki disease in Asia, Europe, and the United States. J Epidemiol. 2012;1201310285.