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International Journal of Pediatrics
Volume 2013 (2013), Article ID 645391, 7 pages
http://dx.doi.org/10.1155/2013/645391
Review Article

Kawasaki Disease: A Clinician’s Update

1School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW 2052, Australia
2The Sydney Children’s Hospitals Network, Randwick and Westmead Campuses, Sydney, NSW, Australia

Received 4 August 2013; Accepted 4 September 2013

Academic Editor: Joel R. Rosh

Copyright © 2013 Nathan Jamieson and Davinder Singh-Grewal. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aims. Kawasaki disease is an acute systemic vasculitis and is the most common cause of acquired heart disease in children in the developed world. This review aims to synthesise recent insights into the disease and provide an update for clinicians on diagnostic and treatment practices. Methods. We conducted a review of the literature exploring epidemiology, aetiology, diagnosis, and management of Kawasaki disease. We searched MEDLINE, Medline In-Process, Embase, Google Scholar, and reference lists of relevant articles. Conclusions. Kawasaki disease is a febrile vasculitis which progresses to coronary artery abnormalities in 25% of untreated patients. The disease is believed to result from a genetically susceptible individual’s exposure to an environmental trigger. Incidence is rising worldwide, and varies widely across countries and within different ethnic groups. Diagnosis is based on the presence of fever in addition to four out of five other clinical criteria, but it is complicated by the quarter of the Kawasaki disease patients with “incomplete” presentation. Treatment with intravenous immunoglobulin within ten days of fever onset improves clinical outcomes and reduces the incidence of coronary artery dilation to less than 5%. Given its severe morbidity and potential mortality, Kawasaki disease should be considered as a potential diagnosis in cases of prolonged paediatric fever.