Kawasaki Disease
Kawasaki disease is a rare condition in children that causes the arterial walls, including those of the coronary arteries, to become inflamed. The disease is not contagious and cannot be prevented. Kawasaki disease mainly affects children younger than 5 years of age, and occurs more frequently in boys than girls. The disease is seen more in children of Japanese or Korean descent, but can occur in children of any racial or ethnic group.
Kawasaki disease is also called mucocutaneous lymph node syndrome because it also affects lymph nodes, skin, and the mucous membranes inside the mouth, nose and throat. While the symptoms of Kawasaki disease, such as a high fever and peeling skin, can be alarming, the disease usually has a good outcome; most children recover from Kawasaki disease completely without any residual problems.
Causes of Kawasaki Disease
The underlying causes of Kawasaki disease are not known, but the disorder was first reported in Japan. In spite of the fact that the disease tends to occur in outbreaks, scientists, although they theorize it may be bacterial or viral, do not believe that it is contagious. They do, however, believe that the disease may be linked to some genetic or environmental factors.
Symptoms of Kawasaki Disease
The symptoms of Kawasaki disease occur in three different phases.
First Phase
- Fever lasting for 5 days to a week or more
- Body rash, primarily on the trunk and genital region
- Conjunctivitis: red eyes without thick discharge
- Red, cracked lips and swollen tongue
- Red, swollen palms and soles
- Swollen lymph nodes
Second Phase
- Abdominal pain
- Peeling skin, especially fingertips and toes
- Vomiting
- Diarrhea
- Joint pain
During the third phase of Kawasaki disease, symptoms usually abate, unless there are complications. It may, however, take up to 2 months for the child's energy level to return to normal.
Diagnosis of Kawasaki Disease
Because there is no specific test available to diagnose Kawasaki disease, an important part of the diagnostic process consists of ruling out diseases that can cause similar symptoms, including scarlet fever, measles, juvenile rheumatoid arthritis, and Rocky Mountain spotted fever. These and other diseases are ruled out through blood tests, urine tests, and heart tests, such as electrocardiograms (EKGs) and echocardiograms.
Treatment of Kawasaki Disease
It is important to treat Kawasaki disease as promptly as possible. When treatment is begun within 10 days of onset, the possibility of residual complications is greatly reduced. Treatments used to prevent complications include infusions of gamma globulin to lower risk of coronary artery problems and administration of high doses of aspirin to treat inflammation. Because of the risk of complications, Kawasaki disease is usually treated in a hospital setting.
Without treatment, Kawasaki disease typically lasts for about 12 days. With gamma globulin infusions, the child's condition may improve much sooner. Even after the child has no fever, low-dose aspirin may be administered for at least 6 weeks to prevent blood clotting. While aspirin use in children is usually contraindicated because of the risk of Reyes syndrome, in cases of Kawasaki disease, the benefits of aspirin usage outweigh its risks.
Complications of Kawasaki Disease
The most common complications of Kawasaki disease are heart-related. If an aneurysm occurs in a coronary artery, it is possible that the patient may require anticoagulant medications, angioplasty, the placement of a stent, or even a coronary artery bypass graft. Other possible heart complications of this disorder include aneurysm, vasculitis, heart arrhythmia, and heart attack. As long as the patient's condition is carefully monitored, however, most children who become ill with Kawasaki disease, fully recover and suffer no residual damage.