Kawasakiapp

Incident and Keys

Kawasaki Disease is an acute vasculitis of small and medium vessels. It is the main cause of acquired heart disease in children in developed countries.

  • 80-85% of cases occur in under 5 years.
  • Higher incidence in Asian ancestry, but prevalent worldwide.
  • Without treatment, 25% develop coronary aneurysms (vs < 5% with early IVIG).

Clinical Findings (CREAM)

C
Conjunctivitis: Bilateral, bulbar, non-exudative. Respect limbo.
R
Rash (Exanthema): Polymorphic (maculopapular, erythema multiforme), non-vesicular. Accented in English.
E
Tips: Acute: palmo-plantar indurated erythema and edema. Subacute: periungual peeling.
A
Adenopathy: Cervical, usually unilateral, >1.5 cm. (It is the least frequent criterion).
M
Mucous membranes: Strawberry tongue, erythematous, dry, fissured or bleeding lips.

Clinical Evaluation

Enter the patient's data to obtain the diagnosis and treatment regimen.

days

*Day 1 is the first day of documented fever.

Main Clinical Criteria

Kobayashi Score

Calculate the risk of IVIG resistance. A high score may indicate the need for adjunctive primary systemic corticosteroids (e.g. methylprednisolone).

Sodium (Na) ≤ 133 mmol/L
sick days at start of tx ≤ 4
AST (GOT) ≥ 100 IU/L
Neutrophils ≥ 80%
Platelets ≤ 300,000/mm³
CRP ≥ 10 mg/dL
Age ≤ 12 months