Kawasaki Disease and Purpura Differences

Written by Zeng Hai Jiang
Pediatrics
Updated on February 17, 2025
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The clinical manifestations of Kawasaki disease include fever lasting more than five days, ineffective antibiotic treatment, rashes, transient swelling of the cervical lymph nodes, conjunctival congestion, strawberry tongue, cracked lips, hard swelling of fingers and toes, and desquamation around the nails and anal region during the recovery phase.

Allergic purpura is mainly manifested by rashes, which are generally hemorrhagic rashes below the buttocks, symmetrical on the lower limbs, raised above the skin surface, and usually without fever. Besides rashes, allergic purpura can also involve joint pain, abdominal pain, or allergic purpuric nephritis among other conditions.

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Written by Li Jiao Yan
Neonatology
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Is it normal for Kawasaki disease to have a lower temperature?

The etiology of Kawasaki disease is currently unclear; its primary pathological feature is systemic vascular inflammation. Kawasaki disease typically presents with fever, high fevers ranging from 39 to 40 degrees Celsius. If a patient with Kawasaki disease has a lower temperature, it may indicate that the condition is quite severe. For example, children generally have weaker immune systems, or if they have a severe co-infection, hypothermia may occur. In this case, it is recommended that doctors perform further examinations and intensify treatment. Therefore, a lower temperature in Kawasaki disease is also abnormal. Normally, the body temperature should gradually return to the normal range, and both hypothermia and hyperthermia are definitely abnormal conditions.

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Written by Zeng Hai Jiang
Pediatrics
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Causes of secondary recurrence of Kawasaki disease

Kawasaki disease, also known as mucocutaneous lymph node syndrome, commonly affects children and infants under five years old. It is an acute, systemic vasculitic disease. Clinically, it is primarily characterized by persistent fever, bilateral conjunctival congestion, cracked lips, strawberry tongue, rash, hard swelling of hands and feet, fingertip desquamation, and enlargement of cervical lymph nodes. In severe cases, it can lead to coronary artery dilation, coronary artery aneurysms, and thrombotic obstruction. The exact cause of Kawasaki disease is not very clear, but it is mainly believed to be related to infections. The probability of secondary recurrence of Kawasaki disease is about 2%, and its causes mainly have to do with infections, immune factors of the body, genetic factors, and so on.

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Written by Li Jiao Yan
Neonatology
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Is Kawasaki disease serious?

Kawasaki disease is an etiologically unclear disease with a not well-understood pathogenesis. The principal pathological change involves inflammatory changes in the systemic blood vessels, which can affect the coronary arteries and lead to coronary artery aneurysms and dilation. Kawasaki disease is self-limiting, and most cases resolve well, with recurrences seen in 1-2% of cases. For patients without coronary artery lesions, comprehensive examinations are required 1 month, 3 months, 6 months, and 1-2 years after discharge, including physical examinations, electrocardiograms, and echocardiograms, mainly to assess the heart's condition. If not effectively treated, 15-20% may develop coronary artery aneurysms; such cases need semi-annual or annual medical check-ups. Coronary artery aneurysms often self-resolve within two years post-diagnosis, typically leaving functional abnormalities such as thickening of the vessel wall and reduced elasticity. Major artery aneurysms often do not disappear completely and can lead to thrombosis or narrowing of the vessel lumen. Kawasaki disease is one of the common causes of acquired heart disease in children; therefore, if Kawasaki disease is accompanied by severe coronary damage, it may heal well but could lead to heart disease. If it is not a severe case of Kawasaki disease, timely treatment can still result in a good recovery.

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Written by Li Jiao Yan
Neonatology
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Is Kawasaki disease contagious?

Kawasaki disease, also known as mucocutaneous lymph node syndrome, currently has unclear pathogenic mechanisms and the causes of the disease are not well defined. One of its main pathological changes is systemic vasculitis, including the coronary arteries. The disease occurs sporadically or in small epidemics, can happen in any season without clear seasonality, and is generally more common in infants and young children, with eighty percent under five years of age. Kawasaki disease is not a contagious disease, so it does not have significant contagiousness.

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Written by Li Jiao Yan
Neonatology
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How long to take aspirin for Kawasaki disease

The current pathogenesis of Kawasaki disease is not yet clear, but one of its main pathological changes is a systemic vasculitis. During an outbreak of Kawasaki disease, the blood viscosity increases primarily due to platelet aggregation. Typically, oral aspirin is administered to prevent this inflammation and to treat platelet aggregation. The dosage is generally reduced gradually once the fever subsides, with maintenance doses lasting about six to eight weeks. If coronary artery lesions are present, the duration of medication is extended until the coronary arteries return to normal before discontinuing the drug.