Kawasaki Disease

kawasaki disease

Kawasaki disease is an uncommon condition that mainly affects children aged less than 5 years. It most commonly affects children aged 9-12 months. It causes various symptoms throughout the body.

What are the symptoms of Kawasaki disease?

  • A fever (high temperature) which lasts more than five days is usual. In addition, at least four of the following normally develop.
  • Redness of the eyes (conjunctivitis).
  • Changes in the mouth such as a red throat or tongue, or dry and cracked lips.
  • A blotchy red rash.
  • Changes in the hands or feet such as mild swelling or redness.
  • One or more lymph glands in the neck become swollen.

There is no test to confirm the disease. Tests may be done to rule out other diseases that cause similar symptoms, such as measles, scarlet fever, etc.

What causes Kawasaki disease?

The cause is not known. The symptoms seem typical of a viral infection. However, it is not contagious. There seems to be some genetic tendency that increases the risk of developing the condition.

How does the illness progress?

Typically, fever develops first and then the other symptoms develop after a few days. Often, the symptoms that develop after the fever has started develop one after each other.
Any child suspected of Kawasaki disease is normally admitted to hospital, even if they appear to have a mild illness. A heart scan is normally done to look for complications. If complications do occur, they usually develop a week or so after the symptoms listed above.

What are the possible complications of Kawasaki disease?

Heart problems

Without treatment, about 1 in 5 children who have Kawasaki disease develop inflammation of the blood vessels to the heart (coronary arteries). This can cause a swelling of a section of an artery, which is called an aneurysm. A coronary artery aneurysm usually causes no symptoms. Over time it often goes away and the artery returns to normal. Serious problems may develop in some children with an aneurysm. The most serious is that a thrombosis (clot) may develop in the aneurysm and damage the heart (a heart attack).

If an aneurysm does occur, it starts to develop a week or more after the fever and other acute symptoms begin. Treatment within 10 days of symptoms starting often prevents this complication. This is why it is important to diagnose and treat Kawasaki disease in the early stages.

What is the treatment for Kawasaki disease?

Aspirin. This is one of the few times aspirin is given to children. Aspirin helps to reduce the inflammation in the coronary arteries.

Gammaglobulin. This is an antibody mixture obtained from human blood. It is given by an infusion into the bloodstream.. It may modify the response of the immune system in some way to prevent inflammation in the arteries.

A combination of aspirin and gammaglobulin given within 10 days of the onset of Kawasaki disease reduces the chance of heart complications.

Research continues to search for better treatments. For example, recent research suggests that steroid drugs, abciximab, infliximab and methotrexate, may be of benefit to prevent complications

What is the prognosis?

Without treatment, most children make a full recovery but complications develop in some cases. With early treatment, complications are much less likely to develop. Repeat heart scans are usually advised over several weeks.

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