Kawasaki Disease Follow Up Guidelines
This article provides an overview of the guidelines for follow-up care for patients with Kawasaki disease, including recommendations for monitoring and potential complications.
Kawasaki disease is an acute febrile illness that primarily affects children under the age of five. It is characterized by inflammation of the blood vessels throughout the body, and if left untreated, it can lead to serious complications such as coronary artery aneurysms. The standard treatment for Kawasaki disease is intravenous immunoglobulin (IVIG) and aspirin, which has been shown to reduce the risk of coronary artery complications. However, even with appropriate treatment, patients with Kawasaki disease require long-term follow-up care to monitor for potential complications and assess their overall health.
The guidelines for follow-up care for patients with Kawasaki disease are based on the risk of developing coronary artery complications. Patients are categorized into low, medium, or high risk based on their initial presentation and response to treatment. Low-risk patients have no evidence of coronary artery abnormalities on their initial echocardiogram and have a normal physical exam at the time of discharge from the hospital. Medium-risk patients have transient coronary artery abnormalities that resolve within six to eight weeks of their illness, while high-risk patients have persistent or giant coronary artery aneurysms.
For low-risk patients, the guidelines recommend a baseline echocardiogram before discharge from the hospital, followed by repeat echocardiograms at two weeks and six to eight weeks after the illness. If all of these echocardiograms are normal, no further testing is needed, and the patient can be discharged from cardiology follow-up. However, if any of the echocardiograms show abnormalities, the patient may need long-term cardiology follow-up to monitor for potential complications.
For medium-risk patients, the guidelines recommend a baseline echocardiogram before discharge from the hospital, followed by repeat echocardiograms at six to eight weeks and six months after the illness. If all of these echocardiograms are normal, the patient can be discharged from cardiology follow-up. However, if any of the echocardiograms show abnormalities, the patient may need long-term cardiology follow-up to monitor for potential complications.
For high-risk patients, the guidelines recommend a baseline echocardiogram before discharge from the hospital, followed by repeat echocardiograms at two weeks, six to eight weeks, and six months after the illness, and then annually thereafter. These patients require long-term cardiology follow-up to monitor for potential complications and assess the need for additional interventions, such as anticoagulation or cardiac catheterization.
In addition to monitoring for coronary artery complications, patients with Kawasaki disease also need regular follow-up care to assess their overall health and well-being. This may include evaluations of growth and development, assessment of cardiac risk factors such as hypertension and hyperlipidemia, and monitoring for potential long-term complications such as vasculitis or autoimmune disorders.
It is important for healthcare providers to be aware of the guidelines for follow-up care for patients with Kawasaki disease and to ensure that patients receive appropriate long-term monitoring and management. By following these guidelines, healthcare providers can help to identify and address potential complications early, and ultimately improve the long-term outcomes for patients with Kawasaki disease.
