Kawasaki Syndrome

Kawasaki Syndrome
Presentation by: Anna Mae Smith, MPAS, PA-C
Lock Haven University

* An acute, distinct, self-limited, febrile disease of children
o Mucocutaneous lymph node syndrome
o vasculitis of coronary blood vessels with potential dilation, aneurysms, thrombosis, rupture, or myocardial ischemia
o 25% develop cardiac sequelae
* Incidence/Prevalence in USA: Worldwide, affects all races but most prevalent in Japan
* In the US, the annual incidence rate is 0.6 cases/100,000 children under 5 years old
* Seasonal variation - increased in winter and spring.
* Increased outbreaks at 2-3 year intervals
* Predominant age: 1-5 years; 50% are < 2 years old, 80% are < 5 years old. Seldom
* seen after 8 years of age

Diagnostic Criteria

* Fever lasting greater than 5 days plus 4 of the 5 following…
o Polymorphous rash
o Bilat. Conjunctiva injection
o 1 or more mucous mb changes
+ Diffuse injection of oral/pharyngeal mucosa
+ Erythema or fissure of the lips
+ Strawberry tongue
o Acute cervical lymphadenopathy
o 1 or more extremity changes
+ Erythema of palms &/or soles
+ Indurative edema of the same
+ Membranous desquamation of the fingertips
Treatment

TAKAYASU ARTERITIS

* Asian population
* Affects young adult populations
* Affects large elastic arteries
o Aorta & major branches & renal

ALLERGIC ANGIITIS/CHURG- STRAUSS SYNDROME

* Occurs in patients with asthma
* Middle age men>women
* Eosinophilia >10% WBC
* Mono or Polyneuropathy
* Transitory Pulmonary infiltrates
* Paranasal sinus Abnormalities
* Biopsy - Extravascular eosinophils

Kawasaki Syndrome