KAWASAKI DISEASE IN PEDIATRICS: DIAGNOSTIC AND THERAPEUTIC CHALLENGES

Abstract

Kawasaki disease is an acute systemic vasculitis affecting small and medium-sized vessels, predominantly in children under five years of age; it is a leading cause of acquired heart disease in children in developed countries. Diagnosis remains challenging due to the lack of a specific laboratory test and the similarity of its clinical manifestations to other febrile exanthematous childhood illnesses; this can delay the initiation of treatment and increase the risk of cardiovascular complications, particularly coronary artery aneurysms. This study aimed to analyze the main diagnostic and therapeutic challenges associated with Kawasaki disease in the pediatric population, based on the latest scientific evidence. It is a systematic literature review conducted using the PubMed, SciELO, LILACS, and Virtual Health Library (VHL) databases, employing keywords related to Kawasaki disease, diagnosis, treatment, and pediatrics, combined using Boolean operators. Primary studies published within the last five years in English, Portuguese, and Spanish were included, provided they addressed clinical aspects, diagnosis, treatment, and disease outcomes. Findings demonstrate that early recognition of clinical signs, combined with the use of laboratory tests and imaging methods—particularly echocardiography—is essential to reducing the risk of cardiovascular complications. Regarding treatment, the early administration of intravenous immunoglobulin combined with acetylsalicylic acid remains the first-line therapy, while additional immunomodulatory therapies are used in refractory cases. The study concludes that early diagnosis, combined with timely treatment and ongoing cardiological follow-up, is crucial for minimizing disease complications and improving the prognosis of pediatric patients.