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Kawasaki disease — SCE Rheumatology MCQ

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ModeratePaediatric rheumatologyKawasaki diseaseSCE Rheumatology

A 63-year-old woman has 6 days of fever, conjunctivitis and rash. Examination shows there are cracked lips and cervical lymphadenopathy. Investigations show platelets are rising and CRP is raised. The diagnosis is established and symptoms remain clinically important despite initial supportive measures. There is no contraindication to disease-modifying or anti-inflammatory escalation. What is the most appropriate management?

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Correct answer: B — High-dose aspirin and IVIG

High-dose aspirin and IVIG is the best answer because high-dose aspirin and ivig is the most appropriate next step for kawasaki disease in this clinical setting. Urgent antibiotics is a plausible distractor, but it does not account for the key discriminator in the stem. Start methotrexate with folic acid and Therapeutic exercise would be more appropriate in a different clinical pattern or at another point in the pathway, while Methotrexate is suboptimal for this presentation. Clinical pearl: rheumatology management is generally treat-to-target, but infection risk, pregnancy plans and shared-care monitoring often determine the safest answer.

Reference: BSR paediatric rheumatology guidance; NICE CKS; BNF for Children