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In children, Kawasaki disease involves swelling (inflammation) in the walls of small to medium-sized blood arteries that transport blood throughout the body. Inflammation of the coronary arteries, which carry oxygen-rich blood to the heart, is a common complication of Kawasaki disease.
Because it involves swelling in glands (lymph nodes) and mucous membranes within the mouth, nose, eyes, and throat, Kawasaki illness was previously known as mucocutaneous lymph node syndrome.
Children with Kawasaki illness may experience a high temperature, swollen hands and feet, skin peeling, and red eyes and tongue. However, Kawasaki disease is frequently curable, and most children recover without major complications if treated within 10 days of onset.
WHAT ARE THE SYMPTOMS OF KAWASAKI DISEASE?
A kid with Kawasaki disease will typically have a temperature of 102.2 F (39 C) for five days or more, as well as at least four of the following signs and symptoms.
- A rash throughout the entire body or in the genital area
- A swollen lymph node in the neck
- Eyes that are extremely red but do not have a thick discharge
- Lips that are red, dry, and cracked, as well as a tongue that is exceedingly red and swollen
- Swollen, red skin on the palms and soles of the feet, with subsequent peeling of skin on fingers and toes
Because the symptoms may not appear at the same time, it is critical to notify your child's health care provider if a sign or symptom disappears.
Other potential signs and symptoms include:
- Pain in the abdomen
- Diarrhea
- Irritability
- Joint discomfort
- Vomiting
Children with a high fever for five days or more and fewer than four of the above signs and symptoms may have incomplete Kawasaki disease. Children with partial Kawasaki disease are still at risk of coronary artery injury and must be treated within 10 days of symptom onset.
Kawasaki illness can mimic the signs of multisystem inflammatory syndrome in children, which has been seen in children with COVID-19 all over the world. Children who exhibit these symptoms will almost certainly be tested for COVID-19.
WHAT ARE THE CAUSES OF KAWASAKI DISEASE?
Although no one understands what causes Kawasaki disease, doctors do not believe it is spread from person to person. Some believe that Kawasaki disease develops as a result of a bacterial or viral infection, or that it is caused by other environmental causes. Certain genes may predispose children to Kawasaki disease.
WHAT ARE THE RISK FACTORS FOR KAWASAKI DISEASE?
Three factors have been identified as increasing a child's risk of acquiring Kawasaki disease.
- Age: Children under the age of five are most vulnerable to Kawasaki disease.
- Sex: Boys are somewhat more prone to acquire Kawasaki disease than girls.
- Ethnicity: Kawasaki disease is more common among children of Asian or Pacific Islander heritage, such as Japanese or Korean.
Seasonal occurrences of Kawasaki disease are common. It commonly happens throughout the winter and early spring in North America.
WHAT ARE THE COMPLICATIONS OF KAWASAKI DISEASE?
In affluent countries, Kawasaki illness is the primary cause of acquired heart disease in children. However, with treatment, few children suffer long-term consequences.
Heart problems include the following:
- Inflammation of blood vessels that provide blood to the heart, most often the coronary arteries.
- Heart muscle inflammation
- Heart valve issues
Any of these conditions can cause heart damage. Inflammation of the coronary arteries can cause arterial wall weakness and ballooning (aneurysm). Aneurysms increase the likelihood of blood clots, which can induce a heart attack or life-threatening internal bleeding.
Kawasaki disease can be fatal in a tiny percentage of children who develop coronary artery issues.
HOW IS KAWASAKI DISEASE DIAGNOSED?
There is no specific test for diagnosing Kawasaki disease. Diagnosis entails ruling out other diseases that have similar signs and symptoms, such as:
- Scarlet fever, caused by streptococcal bacteria, and is characterized by fever, rash, chills, and sore throat.
- Juvenile rheumatoid arthritis
- Stevens-Johnson syndrome, a mucous membrane disorder
- Toxic shock syndrome (TSS)
- Measles
- Tick-borne diseases such as Rocky Mountain spotted fever
To aid in the diagnosis, the health care professional will perform a physical examination and order blood and urine tests. Tests could include:
- Blood tests: Blood tests are used to rule out other disorders and to assess the blood cell count. Kawasaki illness is characterized by a high white blood cell count, as well as anemia and inflammation.
- Electrocardiogram: To measure the electrical impulses of the heartbeat, electrodes are placed to the skin. Heart rhythm issues can be caused by Kawasaki disease.
- Echocardiogram: This test uses ultrasound images to demonstrate how well the heart is performing and can assist discover coronary artery issues.
WHAT ARE THE TREATMENTS FOR KAWASAKI DISEASE?
To lessen the danger of long-term consequences, your child's doctor will want to start Kawasaki disease therapy as soon as possible, preferably while your kid is still feverish. The primary goals of first treatment are to reduce fever and inflammation while also preventing cardiac damage.
Kawasaki disease treatment options include:
- Gamma globulin: Intravenous infusion of an immunological protein (gamma globulin) can reduce the risk of coronary artery disease. This aids in the reduction of vascular irritation.
- Aspirin: Aspirin at high amounts may help relieve inflammation. Aspirin can also help with pain, inflammation, and fever. Once the fever has subsided for 48 hours, the aspirin dose will most likely be reduced.
The Kawasaki therapy is a rare exception to the norm that children should not be given aspirin. Aspirin has been related to Reye's syndrome in children recuperating from chickenpox or flu, a rare but potentially fatal illness. Only under the supervision of a health care expert should children with Kawasaki disease be given aspirin.
Because of the danger of catastrophic consequences, Kawasaki disease is frequently treated in a hospital where doctors can continue to monitor the child.
Following the initial therapy
After the fever has subsided, a kid may need to take low-dose aspirin for at least six weeks – longer if a coronary artery aneurysm develops. Aspirin aids in the prevention of blood clotting.
Children who get the flu or chickenpox while on therapy, on the other hand, may need to discontinue taking aspirin. Aspirin use has been associated to Reye's syndrome, an uncommon but potentially fatal disorder that affects the blood, liver, and brain of children and teenagers following a viral infection.
A youngster may begin to improve immediately after the first gamma globulin treatment. Kawasaki disease lasts roughly 12 days if not treated. Heart issues, on the other hand, may last longer.
MONITORING HEART ISSUES
If your child shows any indicators of cardiac problems, the health care provider may urge regular check-ups to assess your child's heart health, usually 6 to 8 weeks after the sickness began, and then again after six months.
If your child's heart problems persist, he or she may be referred to a doctor who specializes in treating childhood heart disease (pediatric cardiologist). The type of cardiac issue determines the treatment for heart difficulties caused by Kawasaki illness.
Vaccination
If your kid received gamma globulin, you should wait at least 11 months before administering a live vaccine, such as the chickenpox or measles vaccine, because gamma globulin can impair the effectiveness of these immunizations. Inform your child's health care provider that he or she has Kawasaki disease.