Short Communication Article | Open Access
Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi Meghe, Wardha, Maharashtra
*Corresponding author: Dr. Amar M. Taksande, Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi Meghe, India
Received date: 13 May, 2021 | Accepted date: 7 June, 2021 | Published date: 10 June, 2021
Citation: Taksande A, Rao R (2021) Kawasaki Disease in Children. J Pediatr Prim Care 1(1): doi http://dx.doi.org/JPPC2100101
Copyright: © 2021 Taksande A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Kawasaki Disease (KD), previously defined as mucocutaneous lymph node syndrome, is a febrile illness caused by inflammation of the body's medium-sized blood vessels. Tomisaku Kawasaki first described it in 1967 as a self-limited acute vasculitic syndrome of unknown etiology. Intravenous immunoglobulin (IV) and high-dose oral aspirin should be begun within 10 days of disease onset along with aspirin.
Keywords: Kawasaki disease; Fever; Coronary artery; Immunoglobulin
Abbreviations: KD: Kawasaki Disease, ESR: Erythrocyte Sedimentation Rate, CRP: C-reactive protein, MIS-C: Multisystem Inflammatory Syndrome in Children, NT-proBNP: Nterminal-prohormone brain natriuretic peptide
Kawasaki Disease (KD), previously defined as mucocutaneous lymph node syndrome, is a febrile illness caused by inflammation of the body's medium-sized blood vessels. Tomisaku Kawasaki first described it in 1967 as a self-limited acute vasculitic syndrome of unknown etiology. KD has also passed rheumatic fever as the leading cause of acquired heart disease in young children in many countries. More than 80% of cases include young children under the age of five. It affects boys more than girls (M: F 1.5:1). While the exact cause of KD remains unclear, many hypotheses exist, including an infectious disorder triggered by bacteria or bacterial superantigens (streptococcus pyogenes) or a virus infectious etiology, hereditary makeup, and an immunological abnormality. There is no clear lab procedure that can be used to definitively diagnose KD. KD is diagnosed depending on the appearance of specific clinical symptoms. Classic KD needs the presence of fever for at least 5 days and at least four of five of the other signature clinical characteristics of illness. In atypical KD, the patient has a persistent fever but only one or two other symptoms of the disease [1-2].
The above-mentioned clinical characteristics appear sequentially over a few days and do not all have to be present at the same time. Other clinical manifestations of the condition may include aseptic meningitis, urethritis, orchitis, arthritis/arthralgia, stomach pain, vomiting, diarrhea, sterile pyuria, hepatitis, and gallbladder distention. Myocarditis, pericarditis, pericardial effusion, or reduced ventricular activities are also examples of cardiac involvement. Around 25% of untreated patients have coronary artery aneurysms in the second to third week of illness [2-3].
Measles, Adenovirus pneumonia, scarlet fever, Toxic shock syndrome, Drug hypersensitivities including Stevens-Johnson syndrome, Leptospirosis, Juvenile rheumatoid arthritis, and MIS-C (Multisystem Inflammatory Syndrome in Children).
The complication of KD is aneurysms of the coronary arteries and rupture. These aneurysms will lead to heart attacks later in life. Dehydration and reduced movement due to joint inflammation are two other risks.
Intravenous immunoglobulin (IV) and high-dose oral aspirin should be begun within 10 days of disease onset.
Acute stage: 2 g/kg IV immunoglobulin given over 10-12 hours, with aspirin 80-100 mg/kg given orally every 6 hours before the 14th illness day.
Convalescent stage: For 6-8 weeks after the start of the infection, take 3-5 mg/kg aspirin orally once daily. Long-term therapy for coronary heart disease involves aspirin 3-5 mg/kg once daily and clopidogrel 1 mg/kg once (max 75 mg/day).
Patients with large or multiple aneurysms can require clopidogrel, warfarin, or low molecular weight heparin treatment [4-5].
Multisystem Inflammatory Syndrome in Children is a significant differential diagnosis of KDs . The WHO category of the MIS-C applies to children and adolescents aged 0 to 19 years who follow all of the clinical criteria mentioned below:
Some children follow complete or partial conditions for Kawasaki syndrome, but they are diagnosed with MIS-C if they otherwise match the case description
The treatment of the MIS-C is the used of IV immunoglobulin in a single dose of 1-2 gm /kg IV in combination with aspirin with steroid therapy.
Conflict of Interest: None