Multisystem Imaging Manifestations of Kawasaki Disease

• Published in: Radiographics Vol. 42; no. 1; pp. 268 - 288
• Main Authors: Tsujioka, Yuko, Handa, Atsuhiko, Nishimura, Gen, Miura, Masaru, Yokoyama, Koji, Sato, Kozo, Handa, Hideo, Jinzaki, Masahiro, Nosaka, Shunsuke, Kono, Tatsuo
• Format: Journal Article
• Language: English
• Published: United States 01-01-2022
• Subjects: Child; Child, Preschool; Coronary Aneurysm; Coronary Artery Disease; Edema; Humans; Immunoglobulins, Intravenous - therapeutic use; Mucocutaneous Lymph Node Syndrome - complications; Mucocutaneous Lymph Node Syndrome - diagnostic imaging
• ISSN: 0271-5333; 1527-1323
• DOI: 10.1148/rg.210070

Kawasaki disease (KD) is a common pediatric vasculitis syndrome involving medium- and small-sized arteries that is especially prevalent in early childhood (ie, age 6 months to 5 years). The diagnosis of KD is made on the basis of clinical features, such as fever, characteristic mucocutaneous changes, and nonsuppurative cervical lymphadenopathy. However, early diagnosis is often challenging because many children with KD present with atypical symptoms. The most serious complication of KD is coronary artery aneurysm caused by coronary arteritis. Prompt intravenous immunoglobulin therapy reduces the risk of cardiac morbidity. In addition, the systemic extension of KD-related vasculitis during the acute phase causes a variety of multisystem manifestations, including encephalopathy, stroke, retropharyngeal edema, pericarditis, myocarditis, KD shock syndrome, pulmonary lesions, intestinal pseudo-obstruction, gallbladder hydrops, arthritis, and myositis. These complications tend to be more common in affected children with atypical presentation. Radiologists can play an important role in the timely identification of diverse KD-associated morbidities and thus may contribute to the early diagnosis of atypical KD.
RSNA, 2021.