KAWASAKI DISEASE

Kawasaki disease is a rare childhood illness that involves the inflammation of the blood vessels. This is also called mucocutaneous lymph node syndrome because it also affects the lymph nodes, skin, and the mucous membrane inside the mouth, nose, and throat. The symptoms can be severe for several days and can look scary to parents. But then most children return to normal activities.

The disease was first described in Japan by Tomisaku Kawasaki in 1967, and the first cases outside of Japan was reported in Hawaii in 1976. The disease occurs most often in children of Asian and Pacific Island descent, and more likely to affect more boys than girls. The disease is most common in children ages 1 to 2 years and is less common in children older than age 8. It does not spread from child to child.

The cause is unknown, but scientists believe that there is a link between bacteria, viruses, or other environmental factors. The body’s response to a virus or infection combined with genetic factors may cause the disease.

Kawasaki disease can harm the coronary arteries, which carry blood to the heart muscle. Most children who are treated recover from the disease without long-term problems. Your doctor will watch your child for heart problems for a few weeks to a few months after treatment.

Kawasaki disease is a leading cause of acquired heart disease in children. When inflammation of the blood vessels to the heart occurs, it weakens the vessels and may cause it to bulge, known as aneurysm. Aneurysms can increase the risk of blood clots that could lead to heart attack or internal bleeding.

The symptom of Kawasaki disease manifest in different phases.

Symptoms of Kawasaki disease include:

First phase:

  • A fever higher than 102.2 F (39 C) lasting at least 5 days.
  • Red eyes.
  • A rash in the trunk and in genital area.
  • Swollen, red, cracked lips and tongue (strawberry tongue).
  • Swollen, red feet and hands.
  • Swollen lymph nodes in the neck.
  • Irritability

Second phase:

  • Peeling of the skin in the hands and feet
  • Joint pain
  • Diarrhea
  • Vomiting
  • Abdominal pain

Third phase:

Signs and symptoms slowly go away unless complications develop.

Get medical help right away if your child has symptoms of Kawasaki disease. Early diagnosis and treatment can often prevent future heart problems.

DIAGNOSIS

Kawasaki disease can be hard to diagnose, because there is no specific test for it. Your doctor may diagnose Kawasaki through the signs and symptoms of the child and by ruling out similar diseases that can manifest similar to Kawasaki.

The doctor may do physical examination and have your child take other tests to help in diagnosis. Tests include:

  • Urine test. To rule out other disease.
  • Blood test. To rule out other disease and detect the presence of inflammation.
  • Electrocardiogram. This is used to measure the electrical impulses of your child’s heartbeat and detect heart complications.
  • Echocardiogram. This shows ho well the heart is functioning.
  • Chest X-ray. This shows whether the disease has affected the heart.

After your child gets better, he or she will need checkups to watch for heart problems.

 

RECOMMENDED MEDICATIONS

The goals of treatment include:

  • Reducing fever and inflammation to improve symptoms
  • Preventing the disease from affecting the coronary arteries

Initial treatment:

To accomplish those goals, your child’s doctor may recommend:

  • Immunoglobulin (IVIG) medicine. This is given through a vein (intravenous, or IV) to reduce inflammation of the blood vessels.
  • High doses of Aspirin to help pain and fever and to lower the risk of blood clots and inflammation.

Because of the risk of serious complications, initial treatment for Kawasaki disease usually is given in a hospital.

Long-term care and treatment:

Aspirin therapy is often continued at home. Because of the risk of Reye syndrome, do not give aspirin to your child without talking to your doctor. If your child is exposed to or develops chickenpox or flu (influenza) while taking aspirin, talk with your doctor right away.

If the disease causes heart problems, your child may need more treatment and follow-up tests. When Kawasaki disease affects the coronary arteries, they may expand and twist. If this happens, your child’s doctor may prescribe blood-thinning medicines (for example, warfarin). These medicines help prevent blood clots from forming in the affected coronary arteries.

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