Title: Emerging Kawasaki Disease (KD) in Covid 19 Era: 3 Cases in a Month
Authors: Dr Sunil Kumar Agarwalla, Dr Dibya Ranjan Panda
DOI: https://dx.doi.org/10.18535/jmscr/v8i5.74
Abstract
Kawasaki disease is an acute, self-limited vasculitis of unknown aetiology that occurs predominantly in infants and children mostly below 5 years. It is considered the leading cause of acquired heart disease in children in developed countries. Diagnosis is mostly based on clinical features. Atypical Kawasaki diseases are patients who do not meet all the requisite criteria for diagnosis. Treatment includes high dose IVIG and aspirin. Most dreaded complication is coronary artery aneurysm (CAA). CAA occurs in 25-35 % 0f untreated cases and can occur in <5 % cases treated with IVIG. A second dose of IVIG is given if the patient does not improve. Over the last few years, several newer treatment option as second and third line have been explored.
Here we are going to report 3 cases of Kawasaki disease with varied presentation admitted to PIPD MKCG MCH, in the month of April i.e. peak of Covid 19 era.
Keywords: Kawasaki, vasculitis, IVIG, aspirin, coronary artery aneurysm.
References
- Ozen S, Ruperto N, Dillon MJ, et al. EULAR/PReS endorsed consensus criteria for the classification of childhood vasculitides. Ann Rheum Dis. 2006; 65: 936–41. [PMC free article] [PubMed] [Google Scholar]
- Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi [Allergy] 1967;16:178–222. [PubMed]
- Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics. 2004;114:1708–33. [PubMed] [Google Scholar]
- Kawasaki T, Kosaki F, Okawa S, Shigematsu I, Yanagawa H. A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics. 1974;54(3):271-6. Epub 1974/09/01. [Links]
- Laupland KB, Dele Davis H. Epidemiology, etiology, and management of Kawasaki disease: state of art. Pediatr Cardiol. 1999;20:177–83.
- Singh S, Kawasaki T. Kawasaki disease – An Indian perspective. Indian Pediatr 2009;46:563-71.
- Yeung RS. Kawasaki disease: Update on pathogenesis. Curr Opin Rheumatol 2010; 22:551-60.
- JCS Joint Working Group. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS 2013). Circ J 2014;78:2521-62. [Crossref] [PubMed]
- Cho EY, Eun BW, Kim NH, et al. Association between Kawasaki disease and acute respiratory viral infections. Korean J Pediatr 2009;52:1241-8. [Crossref]
- Chang FY, Hwang B, Chen SJ, et al. Characteristics of Kawasaki disease in infants younger than six months of age. Pediatric Infect Dis J 2006;25:241-4. [Crossref] [PubMed]
- Salgado AP, Ashouri N, Berry EK, et al. High Risk of Coronary Artery Aneurysms in Infants Younger than 6 Months of Age with Kawasaki Disease. J Pediatr 2017; 185:112-116.e1. [Crossref]
- Crindle BW, Rowley AH, Newburger JW, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation 2017;135:e927-99. [Crossref].