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Kawasaki disease neurological complications

Neurological complications of Kawasaki diseas

  1. Neurological complications of Kawasaki disease. Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Group. Formats: Summary | PDF (121K) | Citation; Share. Facebook Twitter Google+ Support Center Support Center. External link. Please review our privacy policy..
  2. Other neurologi­cal complications in Kawasaki disease, such as facial palsy, hemiplegia, epilepsy, moyamoya disease and myositis are described in case reports. However, their in­cidence, clinical spectrum and prognosis have not yet been reported
  3. 1. Arch Dis Child. 1998 Aug;79(2):200. Neurological complications of Kawasaki disease. McDonald D, Buttery J, Pike M. PMCID: PMC1717651 PMID
  4. The neurological manifestations of KD were diffuse, presenting as headache, convulsions, somnolence, extreme irritability, signs of meningeal irritation, bulging fontanelles, and facial nerve palsy. The presence of hemiplegia and sensorineural hearing loss were not found in our cohort
  5. al symptoms, meningeal irritation, pneumonia or renal failure. Clinical cases: We describe 4 children with ages ranging from 2 to 12 years who had atypical Kawasaki disease, with neurological and gastrointestinal symptoms as part of the systemic presentation of the disease
  6. Rare Neurological Complication of Kawasaki Disease. Biomed J Sci & Tech Res 31(3)-2020. BJSTR. MS.ID.005100. Received: October 21, 2020 Published: October 27, 2020 Introduction KD Kawasaki disease (KD) or mucocutaneous lymph node syndrome was originally described by Kawasaki in 1967.It is a multisystem vasculitic disease. The diagnosis of KD is.

Kawasaki Disease. Kawasaki disease (KD) is a systemic vasculitis that mainly affects medium-sized vessels, occurring predominately in children under 5 years of age. Neurological complications of KD have been described in children, such as encephalopathy, seizures, cerebral infarction, intracranial hemorrhage, ataxia, and cranial nerve palsy. KAWASAKI DISEASE, a multisystem vasculitis of unknown cause, is an acute illness of early childhood with an estimated annual incidence of 6.2 children per 100,000. 1,2 Cardiac involvement is the most serious complication, but treatment with intravenous γ-globulin (IVGG) can reduce the incidence of coronary artery abnormalities from 20% to less than 5%. 1,3,4 Extreme irritability is also a. Complications. Kawasaki disease is a leading cause of acquired heart disease in children. However, with effective treatment, only a few children have lasting damage. Heart complications include: Inflammation of blood vessels, usually the coronary arteries, that supply blood to the heart Neurological complications of Kawasaki disease [6] D. McDonald, J. Buttery , M. Pike Research output : Contribution to journal › Letter › Other › peer-revie

Neurological complications in Kawasaki disease - ScienceDirec

  1. We have experienced 540 cases with Kawasaki disease over the past 10 years. Six of them (1.1%) had neurological complications with clinical manifesta
  2. Kawasaki disease (KD, also called mucocutaneous lymph node syndrome) is one of the most common vasculitides of childhood [ 1 ]. KD also occurs rarely in adults. It is typically a self-limited condition, with fever and manifestations of acute inflammation lasting for an average of 12 days without therapy [ 2 ]
  3. Cerebral vasculitis is thought to be a possible underlying mechanism of severe neurological complications of Kawasaki's disease (KD), such as cerebral infarct or aneurysm rupture
  4. Stowe RC (2015) Facial nerve palsy, Kawasaki disease, and coronary artery aneurysm. Eur J Paediatr Neurol 19(5): 607-609. Poon LK, Lun KS, Ng YM (2000) Facial nerve palsy and Kawasaki disease. Hong Kong Med J 6: 224-226. Alves NR, Magalhães CM, Almeida Rde F, et al. (2011) Prospective study of Kawasaki disease complications: review of 115 cases
  5. Other organ systems affected include gastrointestinal, cardiovascular, hematologic, mucocutaneous and respiratory, with many exhibiting Kawasaki's disease-like features. The one prior paper to describe neurological symptoms in detail involved 99 children in New York State with confirmed or suspected COVID-19 infection
  6. Abstract Kawasaki disease is an acute vasculitis, that has a classic complication of acquired coronary artery aneurysm. Severe forms with multi‐organ involvement or neurological dysfunction are rare. Cerebral vascular involvement has been related to large‐vessel injury or cardioembolism, leading to focal brain infarction
  7. Uncommon Causes of Stroke - October 200

Neurological complications include aseptic meningitis occurring in 26-50% of cases as well as facial nerve palsy, sensorineural hearing loss, hemiplegia, cerebral infarction and severe lethargy, which have all been reported in various case studies [ 3 - 6 ] The inflammation of Kawasaki disease can damage a child's coronary arteries, which carry blood to their heart. It can also cause problems with lymph nodes, skin, and the lining of a child's mouth,.. Complications of Kawasaki disease. Cardiovascular: heart disease acquired in childhood; coronary artery aneurysms; transient coronary artery dilation; myocardial infarct; rupture of a large coronary artery aneurysm; Other complications: gastrointestinal complications; eye changes; neurological complications; death; Diagnosis Other Kawasaki disease complications have been described, such as aneurysm of other arteries: aortic aneurysm, with a higher number of reported cases involving the abdominal aorta, axillary artery aneurysm, brachiocephalic artery aneurysm, aneurysm of iliac and femoral arteries, and renal artery aneurysm

Long Term Effects of Kawasaki Disease. Page Content. New information has led us to believe that for a subset of patients who had some abnormalities of the echocardiogram in childhood, there can be cardiovascular complications years after the acute phase of illness as a result of inflammation and scarring of the heart and blood vessels Background: Cerebral infarction is a rare neurological complication of Kawasaki disease (KD) and occurs in the acute or subacute stage. There have been no reported cases of late-onset fatal cerebral infarction presenting over 1 year after the onset of KD.Case Presentation: A 5-month-old male patient with KD received timely intravenous immunoglobulin therapy; however, extensive coronary artery. To reduce the risk of complications, your child's doctor will want to begin treatment for Kawasaki disease as soon as possible, preferably while your child still has a fever. The goals of initial treatment are to lower fever and inflammation and prevent heart damage. Treatment for Kawasaki disease may include: Gamma globulin The incidence of encephalopathy / encephalitis as a complication of Kawasaki disease (KD) is 0.09%, according to the 21st nationwide survey (2009-2010) of KD in Japan. 1 Although this complication is extremely rare, coronary aneurysm occurs more frequently in KD patients with neurological complications. Acute disseminated encephalomyelitis (ADEM), also known as postinfectious. Although central nervous system complications occasionally accompany during the acute phase of Kawasaki disease, clinically problematic arrhythmia is quite rare. We report a case accompanied by encephalitis and several kinds of problematic arrhythmia. Following the diagnosis of Taussig-Bing anomaly and coarctation of the aorta, the patient underwent aortic arch reconstruction, an arterial.

Neurological complications of Kawasaki disease

  1. Kawasaki disease (KD) is a clinical diagnosis that requires prompt recognition and management Consider incomplete KD where there is prolonged fever and no alternative cause found Infants and adolescents may present with incomplete KD and are at particularly high risk of developing coronary artery aneurysm
  2. Neurological complications of Kawasaki disease. Sign in | Create an account. https://orcid.org. Europe PMC Neurological complications of Kawasaki disease. McDonald D, Buttery J, Pike M. Archives of Disease in Childhood, 01 Aug 1998, 79(2): 200 DOI: 10.1136/adc.79.
  3. We have experienced 540 cases with Kawasaki disease over the past 10 years. Six of them (1.1%) had neurological complications with clinical manifestation. Two infants had central nervous system involvement with remarkable changes of cerebrum on CT scan during an acute stage, and these findings disappeared completely within six months
  4. To the Editor: Kawasaki Disease (KD) is a multisystem vasculitis with known neurologic involvement, but central nervous system (CNS) complications as initial presentation of KD are extremely rare [].We present two cases of KD with neurologic presentation

After Kawasaki-like disease, brain and neurological damage observed in COVID-19 positive children kids were reported to be at low risk of contraction and complications due to COVID-19. The symptoms of the disease were restricted to fever, shortness of breath, and cough, and the target organ of SARS-CoV-2 was reported to be the lungs. Neurological complications—such as hemiplegia, myositis, epilepsy, and facial nerve palsy—are rare, with a prevalence of 1.1%. 34,35 Sensorineural hearing loss has been identified in patients within the first 30 days and can also be present 6 months after the onset of disease Background: Kawasaki disease is a common vasculitis of childhood in East Asia. The complications following Kawasaki disease mostly included cardiovascular sequelae; non-cardiac complications have been reported but less studied. This study investigated potential epilepsy following Kawasaki disease in Taiwanese children.Objectives: Through National Health Insurance Research Database, we.

Still, gastrointestinal complications, cytokine storm leading to multisystem inflammatory disease or Kawasaki disease-like presentation have been reported in children suffering from COVID-19 [2, 3]. However, neurological complications like seizures and encephalopathy have only been reported in a few case series and single case reports [ 4 ] ovascular, respiratory, musculoskeletal, gastrointestinal, neurological, and genitourinary complications may occur. In the early stage, Kawasaki disease is often manifested by uncommon symptoms, such as pyuria, meningitis, shock, and retropharyngeal or parapharyngeal abscess, which may delay diagnosis and treatment. We have reported a case of Kawasaki disease presenting with mumps and reviewed.

Neurological complications and Japanese encephalitis vaccination SIR—In Denmark we have received three notifications of Kawasaki disease because they recorded exclusive activation of V 2 T-cells of the CD8 type only or an unbiased activation of T cells belonging to all V families, i The prognosis of neurologic complications in Kawasaki disease is generally good. However, four patients have been reported with sequelae, mainly moyamoya disease (one patient), myoclonic seizures (one patient), and mild hemiparesis (two patients) [1. Terasawa K. Ichinose E We also review the neurologic complications associated with KD. AB - We present the first reported case of a child with Kawasaki disease (KD) complicated by meningoencephalitis and an acute focal demyelinating lesion. Neurologic outcome in this patient was excellent without any persistent neurologic deficits

All patients recovered without neurological complications. Conclusions. In our patients with Kawasaki disease, aseptic meningitis induced by IVIG occurred within 48 hours after initiation of IVIG, resolved within a few days, and resulted in no neurological complications, even in patients who did not receive medical treatment overt neurological complications. 2 There were only a limited number of reports of overt cerebral infarction caused by Kawasaki disease. 3,4 We describe an infant with Kawasaki disease who presented with cere-bral infarction and developed multiple thromboses in the coronary arterial aneurysms. These coronar Kawasaki disease (KD) is an acute, multisystem, vasculitic syndrome that can involve any organ system in the body. KD predominantly affects infants and young children. 1 Neurological complications may occur in only 1% to 30% of all patients with KD. These neurological complications include irritability, aseptic meningitis, hemiplegia, cerebral infarction, ataxia, epileptic seizures, cranial.

Neurological involvement in Kawasaki disease: a

  1. Both generalized and localized central nervous system symptoms have been reported in Kawasaki disease. While neurologic complications or symptoms may occur in a small number of patients with Kawasaki disease, the vast majority escape serious central nervous system damage and data suggests that milder central nervous system effects, in the form of cognitive and academic difficulties are rare
  2. Kawasaki disease is a rare childhood disease that develops when the walls of the blood vessels throughout the body become inflamed. Kawasaki disease is also known as mucocutaneous lymph node syndrome. Microscopic polyangiitis affects small blood vessels, often including those in the kidneys and lungs
  3. Kawasaki disease is an acute febrile exanthematous disease that affects children younger than 5 years of age. It is regarded as the most common cause of childhood acquired heart disease, but ocular and neurological problems are among the other important clinical findings. We present a 3-year-old boy who developed bilateral ptosis on day 21, 5 days after intravenous immunoglobulin
  4. Children with congenital heart disease (CHD) are at risk for neurological complications including cerebrovascular accidents (CVAs), cerebral abscess, seizures, developmental delay, and cognitive impairment. The neurological complications, seen in as many as 25% of children with CHD, are the most common extracardiac complications of CHD
  5. Neurological complications of KD include irritability, aseptic meningitis, ataxia, seizures, focal encephalopathy, cranial nerve palsies, cerebral infarction, and transient hemiplegia [].In a prospective study of 115 patients on complications of KD, one patient (0.9 %) had facial nerve palsy [].Most reported cases of facial nerve palsy occur in the convalescent phase, are self limiting.
  6. Doctors around the world have reported features of toxic shock syndrome and Kawasaki disease, in which blood vessels, including the coronary arteries, enlarge or form aneurysms. Some children have also developed gastrointestinal symptoms, excessive blood clotting, kidney injury, or inflammation in the heart

[Neurological manifestations in atypical Kawasaki disease

Kawasaki disease (KD) is a form of acute multisystem vasculitis that presents with various complications, including coronary artery aneurysm. Heart failure and brain damage are rare, but life-threatening complications are associated with KD. Here, we describe a 4-year-old girl who developed intravenous immunoglobulin-resistant KD with both left ventricular failure and acute encephalopathy. On. Kawasaki disease is a systemic vasculitis of unknown etiology that affects the small- and medium-sized blood vessels of the body, particularly the coronary arteries. Since its original description, in Japan in 1967, Kawasaki disease has been reported worldwide in children of all ethnic origins

Giant Coronary-Artery Aneurysm in Kawasaki's Disease — NEJM

Kawasaki disease is a panvasculitis with multisystem involvement of unknown etiology that occurs throughout the world, almost exclusively in children (7). Neurological complications are well recognized in KD occurring in 1-30% of cases (8). Facial palsy was first described by Murayama in 1974 (4). Facial nerve palsy was first considered to be. Title: doi:10.1016/j.cupe.2004.09.002 Created Date: 12/17/2004 3:35:11 P To the Editor: Although neurological manifestations like aseptic meningitis are described in Kawasaki disease (KD), facial nerve palsy is uncommon, with 30 cases reported since 1974 [1]. We describe a 3-y-old girl, refractory to the first dose of IVIG who presented to us with unilateral infranuclear facial nerve palsy any organ system. The neurological complications of KD are rare but have been fairly well described, ranging from aseptic meningitis to cerebrovascular accidents and facial nerve palsy.2 The fi rst case of facial nerve palsy was described in 1974 and in the 30 years since, only slightly more than 30 case

Medicine by Sfakianakis G

Kawasaki disease is an acute inflammatory vasculitis of medium sized arteries, also known as mucocutaneous lymph node syndrome. 1 Kawasaki disease is relatively common, with an annual incidence in the United Kingdom and United States of approximately 9-12 per 100 000 children aged less than 5 years, compared to an age-matched incidence of meningococcal disease of approximately 1 per 100 000. Facial nerve palsy and Kawasaki disease LKH Poon, KS Lun, YM Ng We report on a case of facial nerve palsy associated with Kawasaki disease in a 2-year-old boy. Facial nerve palsy is one of the rare neurological manifestations of Kawasaki disease. Twenty-seven other cases that have been reported in the literature are reviewed of facial nerve palsy in a young infant: Kawasaki disease. Turk J Pediatr 2018; 60: 433-435. Kawasaki disease (KD) is a vasculitis in which the most common complication is development of coronary aneurysms. Neurological complications rarely occur in KD patients such as facial nerve palsy (FNP). FNP associated with KD ma Kawasaki disease usually affects children younger than 5. Kawasaki disease is rare. It affects about 5,000 children in the U.S. each year. If left untreated, Kawasaki disease can lead to heart damage, blood clots and heart attacks. With prompt treatment, however, most children fully recover. Kawasaki disease is an emergency

If Kawasaki disease (KD) is recognized and treated early, children can recover quickly with a decreased chance of developing long-term complications and heart disease. Heart disease develops in 1 out of 4 children diagnosed with KD. The diagnosis of complete KD is based on the presence of ≥ 5 days of fever and ≥ 4 principal clinical. Kawasaki disease can cause heart rhythm complications. Echocardiogram: This test uses ultrasound images to show how well the heart is functioning and can help identify coronary artery abnormalities, if present. Treatment and medications. Kawasaki disease is usually treated in hospital, because of the risk of complications Kawasaki disease is a vasculitis, sometimes involving the coronary arteries, that tends to occur in infants and children between the ages of 1 year and 8 years.It is characterized by prolonged fever, exanthem, conjunctivitis, mucous membrane inflammation, and lymphadenopathy. Coronary artery aneurysms may develop and rupture or cause myocardial infarction

Frontiers Neurological Involvement in Primary Systemic

The good news is that for kids, unlike those adults, this condition is usually treated with relative ease—using the same antibody treatment for mild Kawasaki disease cases, plus additional steroids These cases present like a severe immune response called Kawasaki disease, where blood vessels can begin to leak, and fluid builds up in the lungs and other major organs. Although only some of these children have tested positive for Covid-19, Russell Viner, president of the Royal College of Pediatrics and Child Health, told the New York Times. Multisystem inflammatory syndrome in children (MIS-C), or paediatric inflammatory multisystem syndrome (PIMS / PIMS-TS), is a rare systemic illness involving persistent fever and extreme inflammation following exposure to SARS-CoV-2, the virus responsible for COVID-19. It can rapidly lead to medical emergencies such as insufficient blood flow around the body (a condition known as shock) Kawasaki disease (KD), a systemic inflammatory disorder with medium-sized vasculitis, mostly occurs among children < five years of age. The highest incidence of KD is among the Asian population. The primary treatment of KD is intravenous immunoglobulin (IVIG) administration. Extreme irritability is a common neurologic manifestation among infants, and central nervous system involvement is.

Kawasaki disease occurs most often in Japan, where it was first discovered. The disease is seen more often in boys than in girls. Most of the children who develop this condition are younger than age 5. Kawasaki disease is not well understood and the cause is yet unknown. It may be an autoimmune disorder. The problem affects the mucous membranes. By: Sabrina and Anumita Kawasaki Disease (KD), known also as Kawasaki Syndrome or Mucocutaneous Lymph Node Syndrome (MLNS) is a rare but severe febrile illness which typically manifests in children younger than 5 years of age. KD is the leading source of acquired heart disease in children in the United States. It induces inflammation in the heart region and is known to target the coronary. Summary 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. Kawasaki Disease Definition 1. Kawasaki disease is an acute febrile vasculitic syndrome of early childhood who present with fever, rash, conjunctival injection, cervical lymphadenitis, inflammation of the lips and oral cavity, and erythema and edema of the hands and feet 2. Cardiac involvement occurs in 20 - 25% of patien ts, and the mortalit

The Effect of Kawasaki Disease on Cognition and Behavior

But the possible neurological complications, which were observed, have proven especially perplexing. Meanwhile, an Italian study published in The Lancet found that eight out of ten children with severe Kawasaki-like disease had antibodies to Covid-19, an indication that they had been infected with the virus. But we still don't know. Kawasaki disease is an acute febrile illness of childhood, with a pancarditis and coronary arteritis; neurological complications include an aseptic meningitis, stroke, encephalopathy, and facial palsy: a pathogenetic association with anti-endothelial cell antibodies is postulated. 70, 71 IVIg is well established as the treatment of choice. Prognosis of neurological complications is generally good, although sequelae such as myoclonic seizures, hemiparesis, and moyamoya disease have been reported in a small percentage of patients . Although MRI scans revealed no abnormalities at the acute stage of the disease, the CNS manifestations associated with KD might be due to focal. And then finally there may be what looks like a vasculitis, a Kawasaki disease-like illness, particularly in young children. Alex Rae-Grant, MD: So it sounds like, Jeff, there's a number of different mechanisms of neurological injuries that occur. I had heard there were a number of reported cases of Guillain-Barre syndrome and then a recent.

Coronavirus disease 2019 (COVID-19) is the first coronavirus to cause a global pandemic, 1 and neurologic problems are increasingly recognized among its complications. The United States now has the highest number of cases worldwide. 2 Spread of the virus is projected to continue for months. 3 COVID-19 is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a single. Does your child have MIS-C, COVID-19 or Kawasaki disease? Neurological complications of COVID-19 in children: rare, but patterns emerge. Mar 10, 2021. Neurologic function and COVID-19. Sep 17. Neurologic complications in patients with COVID-19 are common in hospitalized patients [ 5-12 ]. More than 80 percent of hospitalized patients may have neurologic symptoms at some point during their disease course [ 12 ]. Rates vary by geographical location and patient characteristics Objective: To draw attention to complications that might arise in any Kawasaki disease (KD) stage, risk factors contributing to the onset of complications and possible transient or permanent disease sequelae. Methods: Prospective study (clinical cohort) conducted between April 2002 and April 2009 of 115 patients with KD admitted to the Pediatri

Kawasaki disease is an uncommon illness in children that causes fever, swollen lymph nodes, sore throat, rash, redness or swelling of the hands or feet, and conjunctivitis. It is not contagious. Also read about multisystem inflammatory syndrome in children (MIS-C), a disease similar to Kawasaki disease but linked to COVID-19 Kawasaki disease is an acute febrile exanthematous disease that affects children younger than 5 years of age. It is regarded as the most common cause of childhood acquired heart disease, but ocular and neurological problems are among the other important clinical findings. We present a 3-year-old boy who develope Kawasaki disease (also called Kawasaki syndrome) is a rare systemic inflammatory condition that affects children, usually in association with an infection. The most common symptoms are a fever , swollen lymph nodes, and a rash—but heart problems and other complications can occur as well

Kawasaki disease - Symptoms and causes - Mayo Clini

monitoring for adverse effects. We describe 3 patients who developed neurological disease closely asso-ciated with the use of infliximab, a monoclonal antibody that binds to and inactivates TNF-α. All had evidence of polyneuropathy, demyelinating in one and axonal in 2. One patient had a central nervous system syndrome Long-term complications. Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops 7 to 10 years after a person has measles, even though the person seems to have fully recovered from the illness Approximately 50-70% of patients with Kawasaki disease (KD) could present with cervical lymphadenopathy associated with deep neck inflammation, which may result in Grisel's syndrome (GS). Given the possibility of neurological impairment owing to GS, it is important to understand the disease profile in KD. Therefore, we carried out this study to investigate this possible complication of KD. Kawsaki disease can lead to complications like artery enlargement, aneurysms, issues with the lymph nodes, skin, and the lining of the nose, throat and mouth. Some experts hypothesize that the coronavirus could be a trigger for Kawasaki disease

Neurological complications of Kawasaki disease [6

Kawasaki disease: Complications - UpToDat

A Pilot Study Evaluating Cerebral Vasculitis in Kawasaki's

Kawasaki disease is a systemic inflammatory disease commonly associated with thrombocytosis, especially after the first week of illness [4]. The incidence of Kawasaki disease with neurological complications is approximately 1.1-3.7 %. Subdural fluid collection is rarely described in association with Kawasaki disease in the previous literature Complications. Kawasaki disease is a condition that mainly affects children under the age of 5. It's also known as mucocutaneous lymph node syndrome. The characteristic symptoms are a high temperature that lasts for 5 days or more, with: a rash. swollen glands in the neck. dry, cracked lips. red fingers or toes. red eyes

What are the complications associated with Kawasaki syndrome? The most frequent complication is coronary artery aneurysms (ballooning out of blood vessels in the heart). Other organs may be involved as well. Less than 1 percent of patients with Kawasaki syndrome die of the disease and its complications. How can Kawasaki syndrome be prevented Kawasaki disease is a rare condition affecting less than 0.02% of children in the United States. The disease is marked by signs of inflammation such as fever, rash, swelling and redness. There is no known cause for Kawasaki disease. Timely treatment of the disorder greatly reduces the incidence of coronary artery aneurysm, from 25% to around 4% Kawasaki disease (KD) is an acute systemic vasculitis of unknown pathogenesis that affects small and medium-size blood vessels. Coronary arterial lesions are the best known KD complications but many others are well known and involve various anatomical districts in the acute and sub-acute period of KD This study aimed to examine and summarize clinical characteristics of Kawasaki disease (KD) at different ages to further strengthen clinicians understanding of children with KD, improving the level of diagnosis, and reducing coronary artery complications of KD. A total of 398 patients with KD who were diagnosed between January 2016 and December 2017 were reviewed retrospectively The Kawasaki disease is vasculitis multisystem character (Delgado Rubio, 2016), to a specific level, is a pediatric disease that causes inflammation of the arterial walls of the body (Mayo Clinic, 2014). Clinically, this disease can affect arteries, lymph nodes, mucous membranes and even the nervous system (Mayo Clinic, 2014). Thus, some of the most common signs and symptoms usually include.