User:Mr. Ibrahem/Kawasaki disease

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Mr. Ibrahem/Kawasaki disease
Other namesKawasaki syndrome,[1] mucocutaneous lymph node syndrome[2]
A child showing the characteristic "strawberry tongue" seen in Kawasaki disease[3]
SpecialtyPediatrics
SymptomsFever > 5 days, large lymph nodes, rash, sore throat, diarrhea[1]
ComplicationsCoronary artery aneurysms[1]
Usual onset< 5 years old[1]
Duration~ 3 weeks[1]
CausesUnknown[1]
Diagnostic methodBased on symptoms, ultrasound of the heart[1]
Differential diagnosisScarlet fever, juvenile rheumatoid arthritis, paediatric multisystem inflammatory syndrome[4][1]
MedicationAspirin, immunoglobulin[1]
PrognosisMortality 0.2% with treatment[3]
Frequency8–124 per 100,000 people under five[5]

Kawasaki disease is a syndrome of unknown cause that results in a fever and mainly affects children under 5 years of age.[6] It is a form of vasculitis, where blood vessels become inflamed throughout the body.[1] The fever typically lasts for more than five days and is not affected by usual medications.[1] Other common symptoms include large lymph nodes in the neck, a rash in the genital area, and red eyes, lips, palms, or soles of the feet.[1] Within three weeks of the onset, the skin from the hands and feet may peel, after which recovery typically occurs.[1] In some children, coronary artery aneurysms form in the heart.[1]

While the specific cause is unknown, it is thought to result from an excessive immune system response to an infection in children who are genetically predisposed.[6] It does not spread between people.[7] Diagnosis is usually based on a person's symptoms.[1] Other tests such as an ultrasound of the heart and blood tests may support the diagnosis.[1] Other conditions that may present similarly, including scarlet fever and juvenile rheumatoid arthritis.[8] An emerging Kawasaki-like disease associated with COVID-19 is currently under investigation.[9]

Typically, initial treatment of Kawasaki disease consists of high doses of aspirin and immunoglobulin.[1] Usually, with treatment, fever resolves within 24 hours and full recovery occurs.[1] If the coronary arteries are involved, ongoing treatment or surgery may occasionally be required.[1] Without treatment, coronary artery aneurysms occur in up to 25% and about 1% die.[3][10] With treatment, the risk of death is reduced to 0.17%.[10] People who have had coronary artery aneurysms after Kawasaki disease require lifelong cardiological monitoring.[11]

Kawasaki disease is rare.[1] It affects between 8 and 67 per 100,000 people under the age of five except in Japan, where it affects 124 per 100,000.[5] Boys are more commonly affected than girls.[1] The disorder was first described in 1967 by Tomisaku Kawasaki, a Japanese pediatric, in Tokyo.[5][12]

References[edit]

  1. ^ a b c d e f g h i j k l m n o p q r s t u "Kawasaki Disease". PubMed Health. NHLBI Health Topics. 11 June 2014. Archived from the original on 11 September 2017. Retrieved 26 August 2016.
  2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 1232–34. ISBN 978-1-4160-2999-1.
  3. ^ a b c Kim DS (December 2006). "Kawasaki disease". Yonsei Medical Journal. 47 (6): 759–72. doi:10.3349/ymj.2006.47.6.759. PMC 2687814. PMID 17191303.
  4. ^ Guidance – Paediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PDF), The Royal College of Paediatrics and Child Health, 2020, archived (PDF) from the original on 2 July 2020, retrieved 28 July 2020
  5. ^ a b c Lai, Wyman W.; Mertens, Luc L.; Cohen, Meryl S.; Geva, Tal (2015). Echocardiography in Pediatric and Congenital Heart Disease: From Fetus to Adult (2 ed.). John Wiley & Sons. p. 739. ISBN 9781118742488. Archived from the original on 2017-09-11.
  6. ^ a b McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M, Baker AL, Jackson MA, Takahashi M, Shah PB, Kobayashi T, Wu MH, Saji TT, Pahl E (2017). "Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association". Circulation. 135 (17): e927–e999. doi:10.1161/CIR.0000000000000484. PMID 28356445."Correction". Circulation. 140 (5): e181–e184. 2019. doi:10.1161/CIR.0000000000000703. PMID 31356128.
  7. ^ Modesti, AM; Plewa, MC (24 July 2019). "Kawasaki Disease". StatPearls. StatPearls Publishing. PMID 30725848. Archived from the original on 10 May 2020. {{cite journal}}: |archive-date= / |archive-url= timestamp mismatch; 6 May 2020 suggested (help)
  8. ^ de Graeff N, Groot N, Ozen S, et al. (2019). "European consensus-based recommendations for the diagnosis and treatment of Kawasaki disease – the SHARE initiative" (PDF). Rheumatology (Oxford). 58 (4): 672–82. doi:10.1093/rheumatology/key344. PMID 30535127. S2CID 54477877. Archived (PDF) from the original on 5 May 2020. Retrieved 28 July 2020.
  9. ^ Galeotti C, Bayry J (2020). "Autoimmune and inflammatory diseases following COVID-19". Nature Reviews. Rheumatology. doi:10.1038/s41584-020-0448-7. PMID 32499548.
  10. ^ a b "Merck Manual, Online edition: Kawasaki Disease". 2014. Archived from the original on 2010-01-02. Retrieved Aug 26, 2016.
  11. ^ Brogan P, Burns JC, Cornish J, et al. (2020). "Lifetime cardiovascular management of patients with previous Kawasaki disease". Heart. 106 (6): 411–20. doi:10.1136/heartjnl-2019-315925. PMC 7057818. PMID 31843876.
  12. ^ Kawasaki T (March 1967). "[Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children]". Arerugi. 16 (3): 178–222. PMID 6062087.
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