What is Kawasaki disease ?
It is a syndrome that results in inflammation of the walls of both the medium and small-sized arteries occurring across the body, which include the coronary arteries which carry blood to the cardiac muscle. Kawasaki disease is also referred to as mucocutaneous lymph node syndrome, as it affects the skin, lymph nodes and the mucous membranes present within the nose, mouse and throat.
The symptoms of Kawasaki disease like peeling of the skin and high body temperatures can be quite frightful. However, one can take solace from the fact that the condition is mostly curable and most affected children tend to experience recovery from Kawasaki disease, without any severe abnormalities
Kawasaki Disease Symptoms
The signs and symptoms of Kawasaki disease occurs in three phases.
- The symptoms of the first phase are as follows:
- Fever, with temperatures that are greater than 38.5 C or 101.3 F. It persists for 1 to 2 weeks.
- A rash appears on the major portion of the body, i.e. the trunk, as well as in the genital region
- Severely reddened eyes or conjunctivitis, not accompanied by thick drainage
- Dry, reddish and cracked lips along with intensely reddish, inflamed tongue, i.e. strawberry tongue
- Swelling of the lymph nodes of neck and possibly of other regions
- The soles of the feet and the palms of the hands may experience swelling and reddish skin
- The symptoms of the second phase are as follows:
- The skin on the feet and hands may elicit peeling of skin, particularly of the toes and fingers. Such peeling may occur in large sheets
- Pain in the abdomen
- Pain of the joints
- In the third phase of Kawasaki disease, there is gradual fading away of the signs and symptoms, unless there is development of complications. It can take as long as 8 weeks, before the levels of energy in the patient return to normalcy.
The complications of Kawasaki disease are as follows:
- Kawasaki disease is a major cause of acquired cardiac disease in children. Nearly one in five affected children develops cardiac abnormalities. However, only a minor section experience lasting damage.
- Some of the cardiac complications are:
- Myocarditis or inflammation of the cardiac muscle
- Dysrhythmia or abnormal cardiac rhythm
- Mitral regurgitation or cardiac valve problems
- Vasculitis, or inflammation of blood vessels, especially of the coronary arteries that aid blood flow to the heart
- Any of the above listed complications can result in damage of the child’s heart. Inflammation of the coronary arteries can result in bulging and weakening of the arterial wall, i.e. aneurysm, which can elevate the vulnerability of blood clots formation and artery blockage, thereby eventually resulting in a cardiac arrest or near-fatal internal bleeding
- A minor percentage of the patients of Kawasaki disease with coronary artery abnormalities tend to die, even after treatment.
Causes of Kawasaki disease
The exact cause of Kawasaki disease is not known. However, researchers are of the opinion that the syndrome is not contagious and does not spread from one child to another. Several theories associate Kawasaki disease to viruses, bacteria or environmental causes, but none of them have been factually substantiated. It has been found that occurrence of certain gene can increase the vulnerability of the child to developing Kawasaki disease.
Some of the risk factors that are known to increase the susceptibility of children to Kawasaki disease are listed below:
- Boys are somewhat more likely to develop the condition as compared to girls
- Children below the age of five years are at the greatest risk to developing Kawasaki disease
- The incidence rate of Kawasaki disease in higher in children of Asian ancestry, like the Korean or Japanese
Kawasaki Disease treatment
The treatment for Kawasaki disease is usually started as soon as the symptoms appear, so as to prevent the onset of complications. Treatment is initially aimed at lowering the inflammation and fever, and also preventing cardiac damage.
Children with Kawasaki disease are generally hospitalized due to the severe risk of developing complications. Treatment includes:
- Intravenous administration of gamma globulin, an immune protein, so as to reduce the risk to coronary artery anomalies
- As an exception the general rule that children should not be given aspirin, inflammation is treated with the help of high doses of aspirin. Joint inflammation, pain as well as fever can be reduced with aspirin therapy.
- After the reduction of fever, the affected child may need to continue a low dosage of aspirin for up to 8 weeks, and even longer if the child experiences a coronary artery aneurysm. Clotting of blood is also prevented by aspirin intake. However, aspirin therapy is stopped if the child develops chicken pox or flu, during treatment.
- In case the child with Kawasaki disease develops heart problems, then his/her health has to be monitored with regular checkups. Children with a coronary artery aneurysm may require treatment with anticoagulant medications and other procedure such as stent placement, coronary artery angioplasty or a coronary artery bypass graft.
Kawasaki disease pictures