Patients with prior Kawasaki's disease need to plan pregnancies carefully

Renee Page

FORT WORTH, Texas — Nurses and providers should counsel patients with previous Kawasaki’s disease to “plan their pregnancy carefully,” due to the condition’s associated long-term risks for coronary artery aneurism, according to Renee Page, MD, FACOG, associate professor of obstetrics and gynecology at Augusta University.

“If the patient plans to get pregnant, they need to talk to someone who knows about this,” Page told attendees at the Rheumatology Nurses Society Annual Conference. “Pregnancy is a tremendous burden on most organ systems, but the heart is one of the biggest.”

According Page, Kawasaki’s disease is an acute systematic vasculitis of small- and medium-sized arteries that typically occurs in children younger than 5 years. It can be diagnosed through the presence of four out of five possible symptoms: bilateral conjunctival injection, changes in the lips and oral cavity, cervical lymphadenopathy, extremity changes and polymorphous rash.

Nurses and providers should counsel patients with previous Kawasaki’s disease to “plan their pregnancy carefully,” due to the condition’s associated long-term risks for coronary artery aneurism, according to Page.

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Regarding treatment, Page said prednisone, IV immunoglobulin and aspirin “are all OK, especially since your patients aren’t going to be getting pregnant until much later in their lives.”

“You want to plan the pregnancy carefully after your patient tells you, ‘I had Kawasaki’s disease,’” Page said. “If we are talking about a systemic vasculitis of small- and medium-sized arteries, then we have to think about how well our pregnancy is going to be supported.” – by Jason Laday

Reference:

Page R. Bones, joints and babies. Presented at: Rheumatology Nurses Society Annual Conference; Aug. 8-11, 2018; Fort Worth, Texas.

Disclosure: Page reports no relevant financial disclosures.