Doença de Kawasaki

Abstract

Resumo: A doença de Kawasaki é vasculite sistêmica e aguda de etiologia desconhecida. Constitui a principal causa de doença cardíaca adquirida em crianças nos EUA. Ocorre mais frequentemente em meninos, 80% dos casos em crianças com menos de cinco anos, sendo rara após os oito anos. Pode atingir crianças de todas as raças, tendo maior incidência entre os descendentes asiáticos. Caracteriza-se por febre, conjuntivite bilateral não exsudativa, eritema e edema de língua, lábios e mucosa oral, alterações de extremidades, linfonodomegalia cervical, exantema polimórfico. Aneurismas e estenoses de artérias coronárias são comuns em percentual que varia de 20 a 25% dos pacientes não tratados, podendo posteriormente levar a infarto agudo do miocárdio e morte súbita. O tratamento com imunoglobulina intravenosa é efetivo e deve ser iniciado precocemente a fim de evitar sequelas cardíacas. O desenvolvimento de testes diagnósticos, terapêuticas mais específicas e a prevenção dessa doença potencialmente fatal em crianças dependem dos contínuos avanços na determinação de sua etiopatogenia. Palavras-chave: Aneurisma coronário; Aspirina; Exantema; Síndrome do linfonodo mucocutâneo Abstract: Kawasaki disease is a systemic acute vasculitis of unknown etiology. It is the leading cause of acquired heart disease in children in the USA. It occurs more frequently in boys and eighty percent of the cases occur in children under five years of age. The disease rarely occurs after eight years and it can affect children of all races, with higher incidence among Asian descendants. Kawasaki disease is characterized by fever, bilateral non-exudative conjunctivitis, redness and swelling of the tongue, lips and oral mucosa, abnormalities in the extremities, cervical lymph node, and polymorphic exanthema. Aneurysms and stenoses of coronary arteries occur in approximately 20 to 25% of untreated patients and subsequently can lead to acute myocardial infarction and sudden death. Treatment with intravenous immunoglobulin is effective and should be initiated early to prevent cardiac sequel. The development of diagnostic tests, more specific treatment approaches and prevention of this potentially fatal disease in children depends on continuous advances in the determination of its pathogenesis. Keywords: Aspirin; Coronary aneurysm; Exanthema; Mucocutaneous lymph node syndrome 1 É mais frequente em crianças, principalmente com menos de cinco anos, porém há relatos na literatura de casos em adultos. A doença de Kawasaki (DK) pode causar vasculite em vários órgãos, como pulmão, intestino, vesí-cula biliar, sistema nervoso central, entre outros, mas o comprometimento cardíaco é o mais significativo, com a formação de aneurismas coronarianos. O diagnóstico é essencialmente clínico, e o tratamento medicamentoso, logo que iniciado, conduz à melhora clíni-ca e reduz os riscos de sequela cardíaca.

Infantile cervical adenopathy and pyrexia with an unexpected sequel

“…As for cases with prolonged fever of more than 5 days with any of 2 to 3 clinical criteria's mentioned above, they are categorised as 'Incomplete KD', which mostly is confirmed by an echocardiography. 11 At times, patients may turn up to the hospital with a cardiac sequelae years after having KD without being able to recall such illness during childhood. 12 Our patient discussed above exhibited fever along with all five criteria which is highly suggestive of KD.…”

Clinical-Epidemiological Relation Between Sars-Cov-2 and Kawasaki Disease: An Integrative Literature

“…It predominantly affects children between six months and four years of age (80-90%). [7][8][9] Even today, its etiology remains unknown. Hypotheses suggest an infectious trigger in the precipitation of the abnormal immune response associated with genetic susceptibility, as well as a greater racial predisposition in Asians, since the incidence rate in these is 20 times higher than in Caucasians.…”

Kawasaki Disease Presenting With Bloody Diarrhea and Acute Renal Failure: First Case

“…3 There are three clinical stages involved in the course of this disease namely acute febrile, subacute and convalescent stages. 4 …”

“…4 Myocarditis, pericardial effusion and Coronary arteritis may also be present during this stage, 5 but in general echocardiography usually shows no aneurysms.…”