KAWASAKI DISEASE

Duration weeks natural history of coronary changes

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Unformatted text preview: is ­ aneurysms rare IVIG most useful Subacute : 10­28 days Stage of desquamation thrombocytosis Coronary Aneurysms ­ (20­25%) Risk of sudden death Convalecent: 4 wks ­ 6/8 weeks­ Beau's lines. Duration (weeks) Natural History of Coronary Changes Natural ­ ­ Coronary A. dialatations, small aneurysms regress within 1­2 yrs. ­ Large aneurysms (> 8 mm) fail to regress ­­­­> thrombosis / MI / Hge ­ sudden death. Investigations :­ Investigations : No diagnostic Lab tests ­ Acute phase reactants Platelet Count 2 D­Echo­cardiography Treatment :­ aims at reducing inflammn Treatment : • I.V.I.G. = 2 G / Kg. Reduces risk of CAA by 90% • Aspirin ­ Anti­inflam. dose ­ 2 wks. Antithrombotic dose ­ as required. • Steroids : reported to CAA incidence Follow up with serial 2 D echo ­ 2 wks, 6 wks, TAKE HOME MESSAGES TAKE HOME MESSAGES • Not all fevers with rash is viral ­ • KD needs prompt diagnosis which is primarily clinical ­ • Early treatment within 10 days of onset with I.V.I.G. markedly reduces coronary complications. • Thrombocytosis with the typical skin changes is pathognomonic of this...
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