Kawasaki Disease: Issues in Diagnosis and Treatment--A Developing Country Perspective

Kawasaki disease (KD) is a common vasculitis in children and is the commonest cause of pediatric acquired heart disease in children in Japan and countries in North America and the European Union. It is now being increasingly reported from several developing countries, including China and India. Diagnosis of KD is based on a set of clinical criteria, none of which is individually pathognomonic for this condition. Further, these clinical features appear sequentially over a few days and all findings may not be present at a given point of time. Like many other vasculitides, there is no confirmatory laboratory test for KD. Treatment of KD involves use of intravenous immunoglobulin (IVIg) and aspirin. IVIg is an expensive product and poses several difficulties for patients in developing countries who may find it difficult to access therapy even if a diagnosis of KD has been made in time. In this review, the authors discuss some of these challenges that pediatricians have to face while managing KD in resource constrained settings.