Kawasaki disease complications

The common complications of Kawasaki disease include:

1. Coronary artery disease: study revealed coronary artery ectasia is 46%, 21% of coronary artery aneurysms. Use two-dimensional echocardiography examination to found that the expansion in the incidence of coronary artery 3 days to appear, most in the 3 to 6 months faded. Incidence of the first 6 days of coronary artery aneurysms can be measured, 2 ~ 3 weeks the highest detection rate, the first four weeks after the emergence of new diseases rarely. The incidence of coronary artery aneurysm is 15 ~ 30%, clinical myocarditis did not indicate the presence of coronary artery involvement. Coronary artery aneurysm with a clear-related incidence of some risk factors include age of less than 1-year-old boy, sustained more than 14 days of fever, anemia, WBC in 30 × 109 / L or more, erythrocyte sedimentation rate of more than 100mm / h, C-reactive protein significantly or high, and the occurrence of serum albumin to reduce those body aneurysms. The majority of coronary artery aneurysms after was self-limiting, the majority of the 1 ~ 2 years to subside.

The coronary artery disease and its backbone to accrued proximal left anterior descending coronary artery the most common, followed by a rare left circumflex branch. Isolated remote rare aneurysm. Generally the extent of serious coronary heart disease is divided into four degrees:

1) normal (0 degrees): coronary artery without expansion.

2) mild (Ⅰ degrees): ectasia obvious limitations, diameter <4mm.

3) moderate (Ⅱ degrees): for single, multiple or broad, inner diameter of 4 ~ 7mm.

4) severe (Ⅲ degrees): larger tumor diameter ≥ 8mm, more extensive, involving more than one. Approximately 5% incidence of poor prognosis. Coronary artery disease is therefore close follow-up should be reviewed regularly by echocardiography. Usually within four weeks in the incidence of examination 1 week later in February, six months to review, then review the changes at least once a year. To have symptoms of serious coronary patients and those who should be involved coronary angiography. MRI can accurately assess the extent of coronary artery stenosis and occlusion and distal lesions. Due to blocked blood vessels leading to end cavity can occur transient myocardial ischemia, ventricular fibrillation and other serious complications.

The indications for coronary angiography: There are symptoms of myocardial ischemia; sustained heart valve disease; X-ray film showed coronary artery calcification; Echocardiography showed coronary artery aneurysm lasting.

2. Gallbladder hydrops: more see in the subacute stage, can occur with severe abdominal pain, abdominal distension and jaundice. Palpable mass in the right upper quadrant, abdominal ultrasonography can confirm that. Most of the natural recovery and even may be complicated by paralytic ileus or intestinal bleeding.

3. Arthritis or joint pain: occurs in the acute phase or sub-acute phase, the size of the joints can be affected, 20% of cases met with, with the condition and recover better.

4. The nervous system changes: the acute phase, including aseptic meningitis, facial paralysis, hearing loss, acute encephalopathy and febrile seizures, is caused as a result of vasculitis, clinical found to restore faster, prognosis is good. Aseptic meningitis in which the most common, the occurrence rate of about 25%. Disease occurred in more than 2 weeks early. Some children with increased intracranial pressure, the performance of pre-eminence chimney. A small number of children with neck stiffness, there are drowsiness, eyes staring, coma, such as disturbance of consciousness. Mild increase in cerebrospinal fluid lymphocytes, sugar, chloride and normal, the vast majority of the normal protein accountants. Clinical symptoms disappeared in a few days, was particularly prevalent in the severe patients with facial paralysis, often peripheral palsy may be due to the magnitude of inflammatory response of vascular nerves, or adjacent to the site of vascular lesions, such as aneurysm formation, arterial expansion, a transient suppression caused by the facial nerve. Recovery due to middle cerebral artery stenosis or occlusion cause paralysis of limbs, the after-effects left over easy, very rare.

5. Other complications: pulmonary vascular inflammation in the lung X-ray patterns showed a plate number or the shadow, occasional occur pulmonary infarction. Acute phase may have urethritis, can see sediment, and mild leukocytosis proteinuria. Iridocyclitis is less. About 2% of patients with aneurysms body to axillary, common iliac artery. Occasional finger and toe gangrene.