Kawasaki Disease

Abstract

Kawasaki disease (KD) is an acute febrile, systemic vasculitis with an unknown etiology that mostly affects children under the age of 5, and it is the most common cause of acquired heart disease in children in developed countries. Despite significant advances in understanding this disease's pathophysiology, diagnostic methods, and treatment options, many aspects remain unclear, so this study aims to provide a comprehensive review of the current knowledge on KD. We reviewed the most recent research (2019-2024) to compile recent advances in the pathogenesis, immunologic mechanisms, clinical manifestations, and treatment of KD, while comparing it with the multisystem inflammatory syndrome in children. KD is associated with elevated inflammatory cytokines, autoantibodies, and endothelial dysfunction, leading to coronary artery lesions. Clinical diagnosis remains challenging and is based on laboratory markers, echocardiography, and differential diagnosis. Intravenous immunoglobulin and high-dose aspirin remain standard treatments, with immunomodulatory therapies for resistant cases. Multisystem inflammatory syndrome in children shares overlapping features but differs in age distribution, systemic involvement, and immune response. Given the critical importance of early diagnosis and management of KD in preventing coronary artery aneurysms, ongoing research is focused on elucidating the underlying mechanisms of the disease and developing novel therapeutic strategies. These efforts aim to enhance patient outcomes and reduce long-term cardiovascular risks.

Keywords: COVID-19; Kawasaki disease; multisystem inflammatory syndrome in children.