Peds 2004;114:1706; Lancet 2004;364:533
Cause:Unknown
Pathophys:A vasculitis of medium-sized vessels and a mucocutaneous lymph node disease
Incidence = 5-8/100 000/yr
Sx: Prolonged high
fever, variety of rashes,
red eyes, nodes
Si:Fever in children age 1-8 yr, nonpitting edema, cervical lymphadenopathy, and desquamation of skin esp palms, perineal area, trunk, lips, as well as nonexudative conjunctivitis, and strawberry tongue (picturesNejm 1995;333:1391)
25% get coronary artery aneurysms later; risk factors = male, age <1 yr, fever after IVIG
r/o measles, scarlet fever, RMSF, leptospirosis, EBV, JRA
Lab:
Hem:ESR, platelets, and wbc elevated
Rx: IgG iv w/i 1st 10 d of fever to prevent complications, 2 gm/kg iv over 10 h × 1 (Nejm 2007;356:663; 1991;324:1633)