Complications of Kawasaki disease

Kawasaki disease (KD) is a systemic vasculitis and the leading cause of acquired heart disease in the developed world. The most severe, frequent complication of KD is the development of coronary artery involvement, although the introduction of treatment with intravenous gammaglobulin has reduced this problem. In those with a history of coronary artery involvement, long-term follow up is recommended. Kawasaki disease can be a widespread vasculitis affecting many systems, and some of the other recognized complications are discussed, including those affecting the skin, nervous system, gastrointestinal tract, musculo-skeletal system, kidneys, lungs, eyes and haematological effects. About 10-30% of children fail to respond to intravenous gammaglobulin and alternative management strategies including the use of steroids are discussed.