Kawasaki’s disease

Author(s):  
Brian W. McCrindle

Kawasaki’s disease is an acute, self-limited, inflammatory vasculitis of unknown aetiology, with a peak incidence under 5 years of age. Clinical features—the diagnosis is made in the presence of persistent fever for 5 days or more and at least four of the following five clinical signs: (1) nonpurulent conjunctivitis, (2) oropharyngeal inflammation, (3) cervical lymphadenopathy, (4) polymorphous exanthem, and (5) erythema of the palms and soles with subsequent desquamation. Incomplete presentations occur in approximately 25% of patients. The primary complications are cardiac, with coronary artery dilation and aneurysms evident in approximately 15 to 25% of untreated patients....

2020 ◽  
pp. 4590-4597
Author(s):  
Brian W. McCrindle

Kawasaki disease is an acute, self-limited, inflammatory vasculitis of unknown aetiology, with a peak incidence under five years of age. Coronary complications can present in adults. Its diagnosis requires persistent fever for five days or more and at least four of the following five clinical signs: (1) non-purulent conjunctivitis, (2) oropharyngeal inflammation, (3) cervical lymphadenopathy, (4) polymorphous exanthem, and (5) erythema of the palms and soles with subsequent desquamation. Coronary artery dilation and aneurysms occur in 15–25% of untreated patients. Its primary therapy is with intravenous gammaglobulin. Persistent and resolving coronary artery aneurysms are the predominant long-term morbidity. In adults, new presentations of myocardial ischaemia with coronary artery aneurysms may suggest a previous episode of Kawasaki disease during childhood.


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