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Kawasaki disease: five-year experience at Children's National Medical Center
1Otolaryngology-Head and Neck Surgery, Walter Reed Army Medical Center, Washington, D.C. 20307.
Insights
Kawasaki disease (KD) presents with head and neck symptoms in children. Early recognition by otolaryngologists is crucial for timely treatment and preventing serious cardiac complications.
Area of Science:
- Pediatrics
- Otolaryngology
- Cardiology
Background:
- Kawasaki disease (KD) is an acute, multisystem inflammatory condition primarily affecting infants and children.
- A significant percentage (15-25%) of KD patients develop coronary artery aneurysms, increasing risks of myocardial infarction and sudden death.
- Head and neck symptoms frequently serve as initial indicators of KD, necessitating early evaluation by otolaryngologists.
Purpose of the Study:
- To emphasize the importance of otolaryngologist awareness regarding early Kawasaki disease symptoms.
- To highlight the role of prompt diagnosis and therapy in mitigating coronary artery abnormalities.
- To review KD cases with head and neck manifestations to underscore diagnostic challenges and opportunities.
Main Methods:
- Retrospective review of Kawasaki disease cases at Children's National Medical Center over a 5-year period.
- Inclusion criteria focused on patients exhibiting head and neck manifestations upon admission.
- Analysis of 69 KD cases to identify common presenting symptoms and diagnostic patterns.
Main Results:
- All 69 reviewed cases of Kawasaki disease presented with head and neck manifestations.
- The findings reinforce the critical role of otolaryngologists in the early detection of KD.
- Review of literature supports the need for increased professional vigilance for KD.
Conclusions:
- Heightened awareness of Kawasaki disease symptoms among otolaryngologists is essential for early diagnosis.
- Prompt therapeutic interventions can significantly reduce the incidence of coronary artery abnormalities in KD patients.
- Otolaryngologists are uniquely positioned to identify KD early due to the prevalence of head and neck symptoms.
Abstract:
Kawasaki Disease (KD) is an acute multisystem disease that predominately affects infants and children. Coronary artery aneurysms or ectasia may develop in 15-25% of children with the disease and may lead to myocardial infarction or sudden death. Head and neck manifestations are often the presenting symptoms, thus the otolaryngologist may be asked to evaluate a child early in the course of the disease. Otolaryngologist need to be familiar with the early symptoms of this disease so that prompt diagnosis may be made and appropriate therapy instituted. Recent therapeutic advances have been shown to be effective in reducing the prevalence of coronary artery abnormalities. The authors retrospectively reviewed cases of KD seen at Children's National Medical Center over a 5-year period. Sixty-nine cases were included in the reviews and all children exhibited head and neck manifestations upon admission. Our data and review of the relevant literature underscore the need for heightened awareness among our profession in regards to KD.