Complications of Kawasaki disease - abstract

ABSTRACT

Kawasaki disease or mucocutaneous lymph node syndrome (MCLS) is a clinical entity of unknown aetiology affecting mainly infants and young children. It is an acute inflammatory illness whose underlying angiitis affects multiple organs, resulting in high fever, mucocutaneous involvement, cervical lymphadenopathy, and potential complications, the most serious being cardiac disease. Predominantly found in Japan, it is increasingly being diagnosed in other countries. The diagnosis is made by exclusion of other inflammatory illnesses, scarlet fever, Steven-Johnson syndrome, viral exanthemata and collagen vascular disorders. We present a five-year restrospective study of eleven cases seen in Barbados; seven males and four females, aged between three months and thirteen years. Complications seen include carditis and coronary arteritis. Two patients had carditis, one had ST, T-wave changes on ECG and elevated CPK, and one had an arrhythmia. Three patients had suspected coronary artery aneurysms seen on real time echocardiography. Four patients had hepatitis, two hydrops of the gall-bladder and one aseptic meningitis. Treatment is non-specific and consists of supportive treatment and high-dose followed by low-dose salicylates in an attempt to decrease platelet aggregation, thrombotic occlusion of the coronary arateries and subsequent sudden death from myocardial infarction or rupture (AU)