IVIG the Nym

𝙲𝚛𝚎𝚊𝚝𝚞𝚛𝚎 𝙿𝚛𝚘𝚏𝚒𝚕𝚎: 𝙸𝚅𝙸𝙶



This disease is close to my heart because I almost died to KD when I was 12 months old. I was very fortunate to have been under the care of a renowned pediatric cardiologist in my city and was treated with IVIG with full resolution and an unremarkable 2d-echo follow-up in adulthood.

Vasculitis is the inflammation of a vessel wall which may result to ischemia and subsequent necrosis. Kawasaki Disease (KD) is a primary systemic vasculitis of the young and it is relatively rare.

Clinical Criteria for Diagnosis of KD (AHA, 2004)
Fever persisting for 5d or more, plus any 4 of the following clinical criteria:
1. Changes in extremities
++ Acute (erythema of palms/soles, swelling of hands/feet)
++ Chronic (periungual peeling of fingers/toes)
2. Polymorphous exanthem
3. Bilateral bulbar conjunctival injection
4. Changes in lips and/or oral cavity (erythema, cracked lips; diffuse injection of oral mucosa)
5. Cervical lymphadenopathy >1.5 cm (usually unilateral)

Phases of Illness:
Acute phase (first 1 to 2 weeks)
- typical diagnostic features + extreme irritability
- lab findings: leukocytosis, significantly elevated ESR, CRP, and ALT, sterile pyuria.
Subacute phase (lasting several weeks)
- defervescence marks this phase
- clinical findings subside, but w/ significant thrombocytosis (high risk for coronary artery aneurysms!! This happens in ~25% of untreated patients and is the most significant cause of morbidity and mortality because of rupture or thrombosis)
Convalescent phase (25 days to 2 months after fever onset)
- all signs & sx have resolved
- platelets & ESR back to normal values
- Beau's lines may be present (transverse ridges on fingernails)

Treatment: IVIG (2 g/kg) + high-dose aspirin (80-100 mkD) in four divided doses during the acute stage, followed by low-dose aspirin (3 to 5 mkD) until the end of the convalescent phase (several months later).
Second-line treatment: high-dose corticosteroids, TNF inhibitors (infliximab), anticoagulant in patients with coronary aneurysms


𝙿𝚎𝚝 𝙸𝚗𝚏𝚘𝚛𝚖𝚊𝚝𝚒𝚘𝚗


♡ thank you so much to @chaotictreat for the trade!~
♡ joined the family on 9/4/23
♡ this creature belongs to 🆃🆆🅸🅽🅺🅻🅴 ⭐