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Kawasaki disease: a need for earlier diagnosis and treatment

Kawasaki disease (KD) is now the most common cause of acquired heart disease in children and is becoming more common worldwide. Despite this, some medical practitioners in the UK may be unaware of the disorder and of its potential long-term cardiac complications, which for those affected require a specialist, and uninterrupted lifetime clinical management. Increasing numbers of patients who suffered KD in childhood are transitioning to the care of adult services, where there is less awareness and experience of the disorder than in paediatric services. KD is an inflammatory disorder predominantly of young children which is associated with vasculitis of the coronary arteries, leading to aneurysm formation in up to a third of untreated patients. Even if treated, the range of persistent aneurysms is 3%–5%,1 2 but coronary artery dilation may be found in 30% in the acute stage, especially in the younger age group.2 Those with persistent coronary abnormalities, especially patients with large or giant aneurysms, are at lifelong risk of thrombosis and are at risk of developing stenotic lesions during vascular remodelling, which may lead to myocardial ischaemia, infarction or death. Those with smaller or resolved aneurysms …