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pathophysiology of kawasaki disease

[1] Within three weeks of the onset, the skin from the hands and feet may peel, after which recovery typically occurs. Kawasaki disease is the leading cause of acquired heart disease in developed countries. [148] This severe outcome may require further treatment such as percutaneous transluminal angioplasty,[149] coronary artery stenting,[150] bypass grafting,[151] and even cardiac transplantation. [6] Research points to an unidentified ubiquitous virus,[106] possibly one that enters through the respiratory tract. It is characterized by prolonged fever, exanthem, conjunctivitis, mucous membrane inflammation, and lymphadenopathy. [64], Other Kawasaki disease complications have been described, such as aneurysm of other arteries: aortic aneurysm,[65] with a higher number of reported cases involving the abdominal aorta,[66][67] axillary artery aneurysm,[68] brachiocephalic artery aneurysm,[69] aneurysm of iliac and femoral arteries, and renal artery aneurysm. Toxic shock syndrome 5. The higher incidence in Asian populations is thought to be linked to genetic susceptibility. [35] Around 11% of children affected by the disease may continue skin-peeling for many years. Clin Exp Immunol. [144], With early treatment, rapid recovery from the acute symptoms can be expected, and the risk of coronary artery aneurysms is greatly reduced. Kawasaki disease is an acute multisystem inflammatory disease of blood vessels (vasculitis) that most commonly affects infants and young children. -, McCrindle BW, et al. HHS 1. [127] Under this classification scheme for systemic vasculitis, Kawasaki disease is considered to be a necrotizing vasculitis (also called necrotizing angiitis), which may be identified histologically by the occurrence of necrosis (tissue death), fibrosis, and proliferation of cells associated with inflammation in the inner layer of the vascular wall. [143] Additionally, corticosteroid use in the setting of Kawasaki disease is associated with increased risk of coronary artery aneurysm, so its use is generally contraindicated in this setting. [117] Within this classification of childhood vasculitides, Kawasaki disease is, again, a predominantly medium-sized vessel vasculitis. [14] Coronary artery aneurysms occur as a sequela of the vasculitis in 20–25% of untreated children. Kawasaki disease is serious, but most children can fully recover if they are treated … [135][156][157] In the continental United States, Kawasaki disease is more common during the winter and early spring, boys with the disease outnumber girls by ≈1.5–1.7:1, and 76% of affected children are less than years of age. [6][101] The pathogenesis is complex and incompletely understood. The main symptoms were shock, unrest, vomiting, and abdominal pain; chest pain was most common in older children. The intima is mainly composed of endothelial cells, the media of smooth muscle cells and the adventitia of loose connective tissue. [22][23] It typically involves the bulbar conjunctivae, is not accompanied by suppuration, and is not painful. Some genes are susceptible to create the condition for Kawasaki Disease. [14] Children with fever and neck adenitis who do not respond to antibiotics should have Kawasaki disease considered as part of the differential diagnoses. Kawasaki disease is an uncommon illness in children that causes fever, swollen lymph nodes, sore throat, rash, redness or swelling of the hands or feet, and conjunctivitis. [6] It is a form of vasculitis, where blood vessels become inflamed throughout the body. Many other serious illnesses can cause similar symptoms, and must be considered in the differential diagnosis, including scarlet fever, toxic shock syndrome, juvenile idiopathic arthritis, and childhood mercury poisoning (infantile acrodynia). The coronary artery which helps in supplying blood to heart get inflamed causing problem to heart, which can be severe if not get proper treatment. This usually requires rehospitalization and retreatment. [73] This change in the vascular tone is secondary to endothelial dysfunction. [97][98][99][100] A plausible explanation is that it may be caused by an infection that triggers an inappropriate immunologic cascade in a small number of genetically predisposed children. [57] [109] Efforts have been made to identify a possible pathogen in air-filters flown at altitude above Japan. Because children with Kawasaki disease will be taking aspirin for up to several months, vaccination against varicella and influenza is required, as these infections are most likely to cause Reye syndrome. It in 1967, its incidence in the first year after the onset of illness 15-20 of! The features listed above the intima is mainly composed of endothelial cells, the neurological per. 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