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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What is Kawasaki Disease?

Kawasaki disease was first reported in 1967 by Tomisaku Kawasaki in Japan and is also known as mucocutaneous lymph node syndrome. Approximately 15% to 20% of cases experience coronary artery damage after effective treatment. Since 1970, cases have been reported worldwide, with a higher incidence among Asians. As diagnostic capabilities improve globally, the incidence of this disease is decreasing. This disease occurs sporadically or in small epidemics and can occur in any season, most commonly affecting infants and young children, with 80% of cases occurring in children under five years of age. The cause of the disease is unclear, and the mechanism of onset is also not well understood, with the primary pathological change being systemic vasculitis. The main clinical symptoms are high fever between 39 to 40 degrees Celsius, followed by ineffectiveness of antibiotic treatment, and conjunctival congestion. Other symptoms include congested, cracked lips, diffuse congestion of the oral mucosa, indurative edema of hands and feet with emerging erythema, polymorphous skin eruptions and scarlet fever-like rash, and enlarged cervical lymph nodes, which can be unilateral or bilateral, hard and tender, but not red on the surface. There may be complications involving coronary artery damage, and potential complications such as myocarditis, pericarditis, endocarditis, and arrhythmias. Additionally, there may be other associated symptoms such as interstitial pneumonia, digestive system symptoms, joint pain, and arthritis.

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Written by Li Jiao Yan
Neonatology
53sec home-news-image

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.

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Written by Zeng Hai Jiang
Pediatrics
44sec home-news-image

Kawasaki Disease and Purpura Differences

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 Quan Xiang Mei
Pediatrics
1min home-news-image

How to alleviate vomiting in Kawasaki disease

When children with Kawasaki disease experience vomiting, the first step is to refrain from eating and drinking, including water, for one to two hours after vomiting to avoid burdening the stomach and intestines. If vomiting subsides after fasting, there is no need for medication temporarily. However, if there is no significant relief and bloating is evident, it is necessary to treat for bowel movement and gas release. At this time, oral medications that aid in digestion, such as digestive tonics, are acceptable. If relief is still not achieved, intravenous fluid supplementation and medications that enhance gastrointestinal motility can be administered. Parents can also keep the abdomen warm and, centering around the navel, perform clockwise abdominal massages to help alleviate the symptoms of vomiting.

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Written by Shi Ji Peng
Pediatrics
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Kawasaki Disease Aspirin Side Effects

Aspirin is necessary for Kawasaki disease. Considering the pros and cons, aspirin must be used in cases of Kawasaki disease, initially in high doses. However, aspirin indeed has side effects. Some say aspirin is contraindicated for children, as its consumption can lead to Reye's Syndrome. This syndrome involves widespread mitochondrial damage following the intake of salicylate drugs during viral infection recovery, posing risks to the liver and brain. Without timely treatment, it could likely lead to liver and kidney failure, brain damage, or even death. Thus, aside from specific diseases, the use of aspirin is strictly prohibited. These specific diseases include Kawasaki disease, rheumatoid arthritis, etc. Therefore, the use of aspirin in Kawasaki disease is necessary, but it can indeed lead to some side effects.