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  • Updated 12.20.2023
  • Released 04.17.2006
  • Expires For CME 12.20.2026

Kawasaki disease



Kawasaki disease is one of the most common vasculitides in childhood. This inflammatory condition attacks the medium and small arteries with a propensity to damage the coronary arteries, thus, making it the most common cause of acquired heart disease in childhood. Treatment with intravenous immunoglobulin is effective at preventing damage to coronary arteries. In this article, the authors review the symptoms, signs, and pathophysiology of Kawasaki disease, as well as how to differentiate it from multisystem inflammatory syndrome in children (MIS-C) with severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2). The latest treatment recommendations are also reviewed.

Historical note and terminology

Kawasaki disease is a vasculitis of the medium and small arteries with a propensity to damage the coronary arteries. Dr. Tomisaku Kawasaki first reported seven cases of “Non-scarlet fever desquamation syndrome” in 1962 followed by “20 cases of ocular-mucocutaneous syndrome” in 1964. His classic report was published in 1967 and included a description of 50 children with what he described as “pediatric acute febrile mucocutaneous lymph node syndrome with characteristic desquamation of the fingers and toes” (28). In this paper, Dr. Kawasaki described the cardinal characteristics that have since come to classify the illness. In 1975, Kato and colleagues published the first large case series describing the coronary artery abnormalities associated with Kawasaki disease (27). The first published case series describing “mucocutaneous lymph node syndrome” in the United States was reported in 1976 (37). The connection between Kawasaki disease and ensuing coronary artery aneurysm has proven significant. Kawasaki disease has replaced acute rheumatic fever as the most common cause of acquired heart disease in industrialized countries.

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