Kawasaki Disease

What is Kawasaki disease, and how is it diagnosed

Luke Busey

Kawasaki disease is an uncommon illness in children that is characterized by high fever of at least five days’ duration together with at least four of the following five findings:

  1. Inflammation with reddening of the whites of the eyes (conjunctivitis) without pus
  2. Redness or swelling of the hands or feet, or generalized skin peeling
  3. Rash
  4. Lymph node swelling in the neck
  5. Cracking, inflamed lips or throat, or red “strawberry” tongue

Kawasaki disease facts

  • Kawasaki disease is a syndrome of unknown cause that mainly strikes young children.
  • Signs of the disease include fever and redness of the eyes, hands, feet, mouth, and tongue.
  • The disease can be treated with high doses of aspirin (salicylic acid) and gammaglobulin.
  • Kawasaki disease usually resolves on its own within a month or two.
  • Some children with Kawasaki disease suffer damage to the coronary arteries.

How can Kawasaki disease cause serious complications?

  • Children with Kawasaki disease can develop inflammation of the arteries of various parts of the body.
  • This inflammation of the arteries is called vasculitis.
    • Arteries that can be affected include the arteries that supply blood to the heart muscle (the coronary arteries).
    • Vasculitis can cause weakening of the blood vessels and lead to areas of vessel widening (aneurysms).
  • Coronary aneurysms have been reported in up to 25% of those with Kawasaki disease.

What is the treatment for Kawasaki disease?

  • Children affected by Kawasaki disease are hospitalized.
  • Kawasaki disease is treated with high doses of aspirin (salicylic acid) to reduce inflammation and to mildly thin the blood to prevent blood clot formation.
  • Also used in treatment is gammaglobulin administered through the vein (intravenous immunoglobulin or IVIG), together with fluids.
  • This treatment has been shown to decrease the chance of developing aneurysms in the coronary arteries.

What is the prognosis for children with Kawasaki disease?

  • Kawasaki disease generally resolves on its own after four to eight weeks and with early treatment full recovery is usual.
  • However, the outcome is not so favorable in every case. Rarely, Kawasaki disease can cause death from blood clots forming in abnormal areas of widening (aneurysms) of the heart arteries (coronary arteries). Those children with larger aneurysms have a worse prognosis because of this risk.
  • The earlier the diagnosis is made and treatment is begun the better the outcome.
  • Researchers are searching for methods of detecting which children are at risk for the development of aneurysms of the coronary arteries. Further research is under way to investigate a variety of criteria for atypical variants of Kawasaki disease that do not have classical presentations.

 

 

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