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Kawasaki Disease
Kawasaki Disease
Randy R. Richardson, MD; Ryan A. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Mucocutaneous lymph node syndrome; acute febrile mucocutaneous syndrome

            • Definitions

              • Inflammatory disease of small- & medium-sized blood vessels of unknown etiology, occurring mainly in children
                • Manifests mainly with prolonged fever, nonsuppurative conjunctivitis, inflamed mucosal membranes of mouth & lips, cervical lymphadenopathy, maculoerythematous rash, & desquamation of hands & feet

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Echocardiographic Findings

                      • Ultrasonographic Findings

                        • Angiographic Findings

                          • Nuclear Medicine Findings

                            • Imaging Recommendations

                              DIFFERENTIAL DIAGNOSIS

                                PATHOLOGY

                                • General Features

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Gottlieb M et al: Multisystem inflammatory syndrome in children with COVID-19. Am J Emerg Med. 49:148-52, 2021
                                                2. Zhang QY et al: Similarities and differences between multiple inflammatory syndrome in children associated with COVID-19 and Kawasaki disease: clinical presentations, diagnosis, and treatment. World J Pediatr. 17(4):335-40, 2021
                                                3. Lee CH et al: Coronary artery aneurysm in Kawasaki disease: from multimodality imaging. Coron Artery Dis. 31(2):193-4, 2020
                                                4. Matsubara D et al: Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States. J Am Coll Cardiol. 76(17):1947-61, 2020
                                                5. McMurray JC et al: Multisystem inflammatory syndrome in children (MIS-C), a post-viral myocarditis and systemic vasculitis-a critical review of its pathogenesis and treatment. Front Pediatr. 8:626182, 2020
                                                6. Pham V et al: Giant coronary aneurysms, from diagnosis to treatment: a literature review. Arch Cardiovasc Dis. 113(1):59-69, 2020
                                                7. Toubiana J et al: Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 369:m2094, 2020
                                                8. Jindal AK et al: Kawasaki disease: characteristics, diagnosis, and unusual presentations. Expert Rev Clin Immunol. 15(10):1089-104, 2019
                                                9. McCrindle BW et al: The role of echocardiography in Kawasaki disease. Int J Rheum Dis. 21(1):50-5, 2018
                                                10. Miura M et al: Association of severity of coronary artery aneurysms in patients with Kawasaki disease and risk of later coronary events. JAMA Pediatr. 172(5):e180030, 2018
                                                11. Singh S et al: Diagnosis of Kawasaki disease. Int J Rheum Dis. 21(1):36-44, 2018
                                                12. Tsuda E et al: Role of imaging studies in Kawasaki disease. Int J Rheum Dis. 21(1):56-63, 2018
                                                13. McCrindle BW et al: Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 135(17):e927-99, 2017
                                                14. Newburger JW et al: Kawasaki Disease. J Am Coll Cardiol. 67(14):1738-49, 2016
                                                15. Brown LM et al: A practical guide to pediatric coronary artery imaging with echocardiography. J Am Soc Echocardiogr. 28(4):379-91, 2015
                                                16. Harnden A et al: Kawasaki disease. BMJ. 338:b1514, 2009
                                                17. Mavrogeni S et al: How to image Kawasaki disease: a validation of different imaging techniques. Int J Cardiol. 124(1):27-31, 2008
                                                18. Arnold R et al: Visualization of coronary arteries in patients after childhood Kawasaki syndrome: value of multidetector CT and MR imaging in comparison to conventional coronary catheterization. Pediatr Radiol. 37(10):998-1006, 2007
                                                19. Takemura A et al: Utility of coronary MR angiography in children with Kawasaki disease. AJR Am J Roentgenol. 188(6):W534-9, 2007
                                                20. Newburger JW et al: Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics. 114(6):1708-33, 2004
                                                21. Greil GF et al: Coronary magnetic resonance angiography in adolescents and young adults with kawasaki disease. Circulation. 105(8):908-11, 2002
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Mucocutaneous lymph node syndrome; acute febrile mucocutaneous syndrome

                                                          • Definitions

                                                            • Inflammatory disease of small- & medium-sized blood vessels of unknown etiology, occurring mainly in children
                                                              • Manifests mainly with prolonged fever, nonsuppurative conjunctivitis, inflamed mucosal membranes of mouth & lips, cervical lymphadenopathy, maculoerythematous rash, & desquamation of hands & feet

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Echocardiographic Findings

                                                                    • Ultrasonographic Findings

                                                                      • Angiographic Findings

                                                                        • Nuclear Medicine Findings

                                                                          • Imaging Recommendations

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                • Gross Pathologic & Surgical Features

                                                                                  • Microscopic Features

                                                                                    CLINICAL ISSUES

                                                                                    • Presentation

                                                                                      • Demographics

                                                                                        • Natural History & Prognosis

                                                                                          • Treatment

                                                                                            DIAGNOSTIC CHECKLIST

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Gottlieb M et al: Multisystem inflammatory syndrome in children with COVID-19. Am J Emerg Med. 49:148-52, 2021
                                                                                              2. Zhang QY et al: Similarities and differences between multiple inflammatory syndrome in children associated with COVID-19 and Kawasaki disease: clinical presentations, diagnosis, and treatment. World J Pediatr. 17(4):335-40, 2021
                                                                                              3. Lee CH et al: Coronary artery aneurysm in Kawasaki disease: from multimodality imaging. Coron Artery Dis. 31(2):193-4, 2020
                                                                                              4. Matsubara D et al: Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States. J Am Coll Cardiol. 76(17):1947-61, 2020
                                                                                              5. McMurray JC et al: Multisystem inflammatory syndrome in children (MIS-C), a post-viral myocarditis and systemic vasculitis-a critical review of its pathogenesis and treatment. Front Pediatr. 8:626182, 2020
                                                                                              6. Pham V et al: Giant coronary aneurysms, from diagnosis to treatment: a literature review. Arch Cardiovasc Dis. 113(1):59-69, 2020
                                                                                              7. Toubiana J et al: Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 369:m2094, 2020
                                                                                              8. Jindal AK et al: Kawasaki disease: characteristics, diagnosis, and unusual presentations. Expert Rev Clin Immunol. 15(10):1089-104, 2019
                                                                                              9. McCrindle BW et al: The role of echocardiography in Kawasaki disease. Int J Rheum Dis. 21(1):50-5, 2018
                                                                                              10. Miura M et al: Association of severity of coronary artery aneurysms in patients with Kawasaki disease and risk of later coronary events. JAMA Pediatr. 172(5):e180030, 2018
                                                                                              11. Singh S et al: Diagnosis of Kawasaki disease. Int J Rheum Dis. 21(1):36-44, 2018
                                                                                              12. Tsuda E et al: Role of imaging studies in Kawasaki disease. Int J Rheum Dis. 21(1):56-63, 2018
                                                                                              13. McCrindle BW et al: Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 135(17):e927-99, 2017
                                                                                              14. Newburger JW et al: Kawasaki Disease. J Am Coll Cardiol. 67(14):1738-49, 2016
                                                                                              15. Brown LM et al: A practical guide to pediatric coronary artery imaging with echocardiography. J Am Soc Echocardiogr. 28(4):379-91, 2015
                                                                                              16. Harnden A et al: Kawasaki disease. BMJ. 338:b1514, 2009
                                                                                              17. Mavrogeni S et al: How to image Kawasaki disease: a validation of different imaging techniques. Int J Cardiol. 124(1):27-31, 2008
                                                                                              18. Arnold R et al: Visualization of coronary arteries in patients after childhood Kawasaki syndrome: value of multidetector CT and MR imaging in comparison to conventional coronary catheterization. Pediatr Radiol. 37(10):998-1006, 2007
                                                                                              19. Takemura A et al: Utility of coronary MR angiography in children with Kawasaki disease. AJR Am J Roentgenol. 188(6):W534-9, 2007
                                                                                              20. Newburger JW et al: Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics. 114(6):1708-33, 2004
                                                                                              21. Greil GF et al: Coronary magnetic resonance angiography in adolescents and young adults with kawasaki disease. Circulation. 105(8):908-11, 2002