Introduction

Kawasaki disease is a type of vasculitis which is predominately seen in children. Whilst Kawasaki disease is uncommon it is important to recognise as it may cause potentially serious complications, including coronary artery aneurysms.

Epidemiology

  • Incidence: 1.00 cases per 100,000 person-years
  • Peak incidence: 1-5 years
  • Sex ratio: more common in males 1.3:1
Condition Relative
incidence
Kawasaki disease1
Takayasu's arteritis0.26
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

Features
  • high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
  • conjunctival injection
  • bright red, cracked lips
  • strawberry tongue
  • cervical lymphadenopathy
  • red palms of the hands and the soles of the feet which later peel

Investigations

Kawasaki disease is a clinical diagnosis as there is no specific diagnostic test.

Management

Management
  • high-dose aspirin
    • Kawasaki disease is one of the few indications for the use of aspirin in children. Due to the risk of Reye's syndrome aspirin is normally contraindicated in children
  • intravenous immunoglobulin
  • echocardiogram (rather than angiography) is used as the initial screening test for coronary artery aneurysms

Complications

Complications
  • coronary artery aneurysm