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Kawasaki Disease: Patients
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Normally, aneurysms resulting from Kawasaki Disease will decrease in size as the patient ages. Smaller lesions are more likely to heal completely than larger ones, and the younger a patient was at the time of outbreak, the more likely it is for the aneurysms to disappear.
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Experience with percutaneous transluminal coronary angioplasty is very limited in patients who have Kawasaki disease. Intracoronary or intravenous thrombolytic therapy has been used with varying efficacy in selected patients. In some patients, coronary artery obstruction may be severe enough to warrant surgical revascularization.37 Worldwide, at least 13 patients with Kawasaki disease have undergone cardiac transplantation because of severe ischemic disease.38
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If after one year from the diagnosis of Kawasaki Diseasethere is no heart involvement, the patient is often discharged from further cardiology evaluations. The majority of the patients fall in this category, and they have an excellent prognosis.
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There is no specific test available to diagnose Kawasaki disease conclusively. Therefore, a doctor may observe a child's symptoms and rule out other diseases that could be causing them. Once other diseases have been ruled out, the patient's symptoms will be compared with a set of diagnostic criteria. The patient must have a fever lasting five days or longer that does not respond to antibiotics, together with four of the following five symptoms:
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Researchers will use the Biomek and Ciphergen workstations to study blood samples from Kawasaki Disease patients. The highly calibrated machines automatically will prepare hundreds of samples and will use laser-activated mass spectroscopy to detect the abnormal presence of thousands of different proteins.
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In patients with fever lasting more than five days and two or three classic symptoms of Kawasaki disease, CRP and ESR should be measured. If those are high, measurement of serum albumin and serum transaminase levels, complete blood cell count, and urinalysis should be performed.
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