Kawasaki disease sequelae

Written by Yan Xin Liang
Pediatrics
Updated on November 11, 2024
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Kawasaki disease is an autoimmune vasculitis, and since it is vasculitis, it can originate from blood vessels in various parts, including the heart, liver, kidneys, brain, and more. However, it mainly arises from the coronary arteries of the heart.

If Kawasaki disease is not effectively treated, some patients can develop coronary artery dilation and even coronary artery aneurysms. Once a coronary artery aneurysm occurs, its complication includes the risk of rupture and bleeding of the aneurysm, which can be difficult to treat if there is severe bleeding.

If there is some coronary artery dilation, it can lead to the formation of coronary artery thrombosis, which is also a complication it can cause. However, the vast majority of Kawasaki disease cases, if treated effectively, can prevent coronary artery abnormalities. Therefore, as long as the treatment is timely, most cases will not have significant lasting effects.

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Written by Shi Ji Peng
Pediatrics
54sec home-news-image

How is Kawasaki disease diagnosed?

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is an acute febrile rash disease characterized primarily by inflammation of medium and small arteries throughout the body, with a self-limiting nature. Clinically, it mainly presents with fever, rash, mucosal lesions, conjunctival congestion, and non-suppurative enlargement of cervical lymph nodes. If untreated, 20% of cases can lead to coronary artery damage. To diagnose this disease, in addition to typical clinical manifestations, attention must also be paid to various tests such as blood tests, immunological tests, and ultrasound examinations for a comprehensive assessment. Although the clinical characteristics are largely indicative of the disease, ultrasound examination is crucial to check for any dilation of the coronary arteries.

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Written by Yao Li Qin
Pediatrics
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How is Kawasaki disease treated?

Kawasaki disease, also known as mucocutaneous lymph node syndrome, can cause damage to the coronary arteries in untreated children, so it is crucial to treat the disease promptly once diagnosed. This disease generally occurs sporadically or in small outbreaks and can occur in any season, predominantly affecting infants and young children. The main treatment for Kawasaki disease is aspirin, which not only reduces fever but also helps reduce coronary artery lesions. Additionally, intravenous immunoglobulin is administered; however, the use of corticosteroids in Kawasaki disease is still somewhat controversial. Other treatments mainly include antiplatelet aggregation agents such as dipyridamole, and symptomatic supportive care for the child, including fluid supplementation, heart protection, control of heart failure, and correction of arrhythmias. For severe coronary artery lesions, coronary artery bypass surgery may be required. (Please use medication under the guidance of a professional physician.)

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Written by Li Jiao Yan
Neonatology
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Is IgE high in Kawasaki disease?

Kawasaki disease, also known as mucocutaneous lymph node syndrome, has an unclear pathogenesis. It is speculated that certain components of infectious sources, such as superantigens, can activate CD30 T cells and CD40 ligand expression directly by binding with T cell antigen receptor fragments without going through mononuclear macrophages. Under the induction of carrier cells, there is polyclonal activation and reduced apoptosis of B08 cells, resulting in the production of large amounts of immunoglobulins such as IgG, IgM, IgA, and IgE, and cytokines. Therefore, the IgE levels in Kawasaki disease are elevated.

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Written by Shi Ji Peng
Pediatrics
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How long does Kawasaki disease require hospitalization?

Kawasaki disease requires hospitalization and continued medication after discharge. The duration of the hospital stay is mainly determined by the child's clinical symptoms. The child can return home when the fever subsides and the dosage of aspirin is reduced, which may take about four to seven days, although this is just a general scenario. After discharge, medication must continue. If the child's coronary arteries are fine, with no dilation or lesions, a low dose of aspirin can be taken for about two months. If there are issues with the coronary arteries, aspirin must be continuously taken until the dilation resolves before stopping the aspirin, so this period can be quite long.

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Written by Li Jiao Yan
Neonatology
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The recurrence rate of Kawasaki disease

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is a type of pediatric autoimmune disease that commonly affects infants and young children, especially those under the age of five. The exact mechanisms and causes of the disease are still unclear. The primary pathological change is systemic vasculitis, frequently affecting the coronary arteries. The recurrence rate of Kawasaki disease is between 1%-3%, with a few cases experiencing three or even four occurrences. The interval between recurrences ranges from three months to one year, averaging one year and five months. Studies have shown that being younger than three years old at the time of the first episode and having vascular damage are risk factors for recurrence.