About kawasaki's disease

What is kawasaki's disease?

Kawasaki's disease facts

  • Kawasaki's 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's disease usually resolves on its own within a month or two.
  • Some children with Kawasaki's disease suffer damage to the coronary arteries.

What is Kawasaki's disease, and how is it diagnosed?

Kawasaki's 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

The above criteria are used to make a diagnosis of Kawasaki's disease. The terminology "incomplete Kawasaki's disease" is sometimes used for patients with only some features of classical Kawasaki's disease. Most patients are under 5 years of age.

What is mucocutaneous lymph node syndrome?

Mucocutaneous lymph node syndrome is the original name for Kawasaki's disease. The original name was quite descriptive because the disease is characterized by the typical changes in the mucous membranes that line the lips and mouth and by the enlarged and tender lymph nodes. Kawasaki's disease is also sometimes referred to as Kawasaki disease.

What are the symptoms for kawasaki's disease?

The symptoms might not occur at the same time, so it's important to let your child's health care provider know about a sign or symptom that has gone away.

Other signs and symptoms that might develop include:

  • Abdominal pain
  • Diarrhea
  • Irritability
  • Joint pain
  • Vomiting

Children with a high Fever for five or more days who have fewer than four of the above signs and symptoms might have what's known as incomplete Kawasaki disease. Children with incomplete Kawasaki disease are still at risk of coronary artery injury and still require treatment within 10 days of the onset of symptoms.

Kawasaki disease can have symptoms similar to that of multisystem inflammatory syndrome in children, which has occurred worldwide in children with COVID-19. Children with these symptoms will likely be checked for COVID-19, as well.

What are the causes for kawasaki's disease?

No one knows what causes Kawasaki disease, but scientists don't believe the disease is contagious from person to person. Some think that Kawasaki disease happens after a bacterial or viral infection, or that it's linked to other environmental factors. Certain genes might make children more likely to get Kawasaki disease.

What are the treatments for kawasaki's disease?

Children affected by Kawasaki's disease are hospitalized. Kawasaki's 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. Sometimes cortisone medications are given. Persisting joint pains are treated with anti-inflammatory drugs, such as ibuprofen (Advil) or naproxen (Aleve).

Plasma exchange (plasmapheresis) has been reported as effective in patients who were not responding to aspirin and gammaglobulin. Plasmapheresis is a procedure whereby the patient's plasma is removed from the blood and replaced with protein-containing fluids. By taking out portions of the patient's plasma, the procedure also removes antibodies and proteins that are felt to be part of the immune reaction that is causing the inflammation of the disease. Kawasaki's disease that is not responding to the traditional aspirin and gammaglobulin treatments can be deadly. Medications that block the effects of TNF (tumor necrosis factor), one of the messenger molecules in the inflammatory response, are being studied for use in these situations. Examples of TNF-blocking drugs are infliximab (Remicade) and etanercept (Enbrel). Further research is needed to design treatment programs for those who are failing conventional treatments. Pentoxifylline (Trental) is also being studied as a possible treatment for Kawasaki's disease.

What are the risk factors for kawasaki's disease?

Three things are known to increase a child's risk of developing Kawasaki disease.

  • Age. Children under 5 years old are at highest risk of Kawasaki disease.
  • Sex. Boys are slightly more likely than girls to develop Kawasaki disease.
  • Ethnicity. Children of Asian or Pacific Island descent, such as Japanese or Korean, have higher rates of Kawasaki disease.

Kawasaki disease tends to occur seasonally. In North America, it usually occurs in the winter and early spring.

Is there a cure/medications for kawasaki's disease?

Find out all you can about Kawasaki disease so that you can make informed choices with your child's health care team about treatment options.

Most children with Kawasaki disease recover completely. Generally, children who have been treated for Kawasaki get well fast and return to normal activities. If your child's heart has been affected, talk to the pediatric cardiologist about whether activity restriction is needed.

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