[Diagnosis and management of Kawasaki disease]

DIAGNOSIS AND MANAGEMENT OF KAWASAKI DISEASE. Kawasaki disease (KD) is a multi-systemic vasculitis predominantly affecting children under 5 years of age. KD's incidence is 30 times higher in Asia than in France. Elective lesional tropism for coronary arteries makes it the leading cause of acquired heart disease in children in developed countries. Diagnosis is based on the presence of fever of 5 days or more and the presence of at least for clinical criteria of cutaneous-mucosal inflammation. KD is believed to be the result of an aberrant inflammatory response to an infectious trigger in a genetically predisposed individual. Timely initiation of treatment with intravenous immunoglobulin has reduced the incidence of coronary artery aneurysms from 25% to 5%. Severe KD requires rapid treatment intensification. Coronary artery lesions are the main determinant of the prognosis. Acute coronary syndrome in adults can be a result of long-term sequelae of the disease. Different imaging techniques are required to adequately follow these patients according to the American Heart Association recommendations.