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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 :
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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- Fall '11