Monday, April 27, 2015

Kawasaki Disease Key Terms


A list of medical terminology associated with Kawasaki disease with definitions in plain English and links to more detailed information.

Symptoms:
Inflammationinflammation is the protective result of some kind of cellular damage in the body and is marked by redness, swelling, and pain.  When this inflammation occurs in the blood vessels, it is called vasculitis.  In Kawasaki disease, the small to medium blood vessels through the body may experience inflammation, particularly in the coronary arteries of the heart.  Inflammation can also be seen by the chapped lips, strawberry tongue, rash, and reddened palms and soles.
Conjunctiva – the conjunctiva is a thin membrane that covers the inner surface of the eyelid and the white part of the eyeball. 
Nonexudative Bilateral Conjunctivitis – this is a fancy way of saying the eyes are red.  Conjunctivitis is inflammation of the conjunctiva; nonexudative means there is no puss or fluid; and bilateral means the redness occurs in both eyes. 
Anterior Uveitisanterior uveitis is inflammation of the middle layer of the eye.
Oropharyngeal changes oropharyngeal refers to the changes in the lips, mouth, and tongue.  In KD this includes chapped, cracked lips and strawberry tongue.
Strawberry Tongue – with strawberry tongue, inflammation can cause the tongue to become a deep red color and have small, raised bumps – eerily resembling a strawberry. 
Lip Fissures – lip fissures refer to cracked lips.
Lymphadenopathylymphadenopathy is the swelling of a lymph node.  During KD, lymphadenopathy occurs most frequently in one of the lymph nodes of the neck. 
Polymorphous Rash – a rash often accompanies Kawasaki disease, most often found on the trunk of the body.  Polymorphous refers to the fact that the rash can look different on different people. 
Exanthemexanthema is a skin disruption (fancy word for rash) that is usually accompanied by fever, like in Kawasaki disease. 
Erythemaerythema is a fancy word for redness. 
Edemaedema is a fancy word for swelling caused by excess fluid.  In KD, erythema and edema on the hands and feet are a classic symptom. 
Desquamationdesquamation is a fancy word for the peeling or shedding of the skin.  In the later stages of Kawasaki disease, peeling of the skin on the hands and feet may occur. 
Beau’s LinesBeau’s lines are horizontal depressions or grooves in the surface of the nails.  Beau’s lines can occur 1-2 months after the initial fever of Kawasaki disease.
Perianal Erythemaperianal erythema refers to redness around the anus.

Laboratory Terminology:
Urinalysis – a urinalysis is a test that evaluates a sample of urine.  In KD, a urinalysis may show sterile pyuria, pus, or protein in the urine. 
Sterile Pyuriasterile pyuria is the presence of elevated white blood cells found during a urinalysis.
Acute-Phase Reactantsacute-phase reactants are substances in the blood (proteins) that will increase when something is wrong in the body – like during an infection, injury, or trauma.  In Kawasaki disease, acute-phase reactants are almost universally elevated at first and usually return to normal 6-10 weeks after the onset of the illness.  These reactants may be measured with various blood tests, including ESR and CRP.
ESR/SED – ESR stands for Erythrocyte Sedimentation Rate and can also be referred to as SED rate.  This is a blood test that will indirectly measure the amount of inflammation in the body – it will measure the acute-phase reactants, which means that the SED rate will usually be elevated during the beginning phases of Kawasaki disease.
CRP – CRP stands for C-reactive Protein Levels.  This is another blood test that will show if there is inflammation in the body and may be elevated during KD. 
Alpha1-AntitrypsinAlphal-Antitypsin (AAT) is a protein – an acute-phase reactant – found in the blood that may increase during the inflammation found in Kawasaki disease. 
Meprin A and Filamin C – These are 2 urine proteins that researchers have linked to KD as possible biomarkers of Kawasaki disease.
CBC – CBC stands for Complete Blood Count.  This blood test will measure a great deal of things including:
Red blood cells, which carry oxygen
White blood cells, which fight infection
Hemoglobin, the oxygen-carrying protein in red blood cells
Hematocrit, the proportion of red blood cells to the fluid component, or plasma, in your blood
Platelets, which help with blood clotting
During the acute phase of Kawasaki disease, a CBC may show an elevated white blood count (WBC), elevated platelet count, and/or normochromic anemia.
Normochromic AnemiaAnemia is a lack of the proper amount of red blood cells.  There are many different kinds of anemia; in Kawasaki disease, normochromic anemia may be found.  This type of anemia occurs when the hemoglobin content of the red cells as measured by the MCHC is in the normal range.
ECG – an ECG (or EKG) is short for Electrocardiogram. This test uses electrodes attached to the skin to measure the electrical impulses of your child's heartbeat.  It is noninvasive and painless, although you will have to remove the sticky circles from the skin after the test.  
Echo – an echo refers to an Echocardiogram. This test uses ultrasound images to show how well the heart is functioning and provides indirect evidence on how the coronary arteries are functioning.  This is one of the most important tests performed during a Kawasaki disease diagnosis. 
Magnetic Resonance Imaging (MRI) – an MRI creates an image of the body or part of the body using powerful magnets and radio waves.  It can be used to get a clearer image of coronary artery damage associated with Kawasaki disease.
Computed Tomography (CT) – a CT or CAT scan is a special x-ray that takes many cross-section images of the body or part of the body.  It can be used to get a clearer image of coronary artery damage associated with Kawasaki disease.
Cardiac Angiographycardiac angiography is a procedure that guides a special dye, aided by x-ray, through the arteries of the heart.  It is often done in conjunction with cardiac catheterization. 
Cardiac Catheterizationcardiac catheterization involves the insertion of a small tube – a catheter – into one side of the heart.  Many diagnostic tests can be performed during a cardiac catheterization.  With Kawasaki disease, angiography and catheterization are only performed when there are complications such as coronary artery aneurysms. 

Heart Complications:
Coronary Artery – Coronary arteries run along the outside of the heart and are responsible for providing oxygen-rich blood to the heart muscle.  Coronary artery aneurysms are the most common serious complication involved with Kawasaki disease. 
Aneurysm – An aneurysm is a weakened area in the wall of a blood vessel which causes an outpouching or bulge. Aneurysms may be fatal if these weak areas burst, resulting in uncontrollable bleeding.
Arrhythmia – An arrhythmia is any deviation from a normal heart beat.
Arteritisarteritis is inflammation of an artery.
Thrombocytosis thrombocytosis is a condition where your body produces too many platelets.
Cardiomegalycardiomegaly is an enlarged heart.
Myocarditismyocarditis is inflammation of the heart muscle (myocardium).
Pericarditis pericarditis causes swelling and irritation of the pericardium – a thin membrane that surrounds your heart. 
Myocardial Infarction – a myocardial infarction is a heart attack. 

For more information on Kawasaki disease, check out the Kawasaki Disease Resource List

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