Signs of Kawasaki disease (Pediatric blood vessel dz)

Description

Inflammation of the blood vessels. It most commonly affects children ages 18 to 24 months. Most affected children are ill for several days and recover without problems. The disorder affects the mucus membranes, lymph nodes, walls of the blood vessels, and the heart. Rarely, inflammation of blood vessels of the heart can lead to aneurysms and heart attacks.

Symptoms

Persistent fever (greater than 5 days), bloodshot or red eyes (without pus or drainage), bright red cracked lips, red mucous membranes in the mouth, strawberry tongue, white coating on the tongue, red palms and soles of the feet, swollen hands and feet, peeling skin, swollen lymph nodes (often invlovling only one lymph node), joint pain and swelling.

Tests

A history and physical exam will be performed. Tests will be done to identify the areas affected by the inflammation. Heart tests including an echocardiogram and electrocardiogram identify the most serious effects of the disease.

Standard Workup

CBC
Chem 12
UA
X-Ray
EKG

Treatment

Children with Kawasaki disease are admitted to the hospital. Treatment must be started as soon as the diagnosis is made to prevent damage to the coronary arteries and heart. Intravenous gamma globulin is the standard treatment. It is given in high doses. The child's condition usually greatly improves within 24 hours of treatment with intravenous gamma globulin. High-dose aspirin is often given along with intravenous gamma globulin. Despite aspirin and intravenous gama globulin treatment, 10 - 15% of children still develop problems in their coronary arteries. Some research has suggested that adding steroids to the usual treatment routine may improve a child's outcome, but more research is needed.