Kawasaki's disease

Alternative Names

Mucocutaneous lymph node syndrome; Infantile polyarteritis

What is Kawasaki's disease

Kawasaki disease is also known as Kawasaki Syndrome, it is a rare childhood disease. It makes the walls of the blood vessels throughout the body become inflamed. It can affect any type of blood vessel, including the arteries, veins and capillaries. No one knows what causes Kawasaki disease.

Kawasaki disease can't be passed from one child to another. It is mainly treated with medicines. Rarely, medical procedures and surgery also may be used for children whose coronary arteries are affected.

Signs and symptoms

Common symptoms of Kawasaki disease include:

• Extremely bloodshot or red eyes (without pus or drainage)
• Bright red, chapped, or cracked lips
• Red mucous membranes in the mouth
• Strawberry tongue, white coating on the tongue, or prominent red bumps on the back of the tongue
• Red palms of the hands and the soles of the feet
• Swollen hands and feet
• Skin rashes on the middle of the body, NOT blister-like
• Peeling skin in the genital area, hands, and feet (especially around the nails, palms, and soles)
• Swollen lymph nodes (frequently only one lymph node is swollen), particularly in the neck area
• Joint pain and swelling, frequently on both sides of the body

Additional symptoms may include:

• Irritability
• Diarrhea, vomiting, and abdominal pain
• Cough and runny nose

The first symptoms of KS may be a high and persistent fever greater than 102 °F, often as high as 104 °F. A persistent fever lasting at least 5 days is considered a classic sign. The fever may last for up to 2 weeks and does not usually go away with normal doses of acetaminophen (Tylenol) or ibuprofen.

Possible complications

Kawasaki disease is a main cause of acquired heart disease in children. About 1 in 5 children with the disease develops heart problems, but only a small percentage have lasting damage.

Heart complications include:

• Inflammation of the heart muscle (myocarditis)
• Heart valve problems (mitral regurgitation)
• Abnormal heart rhythm (dysrhythmia)
• Inflammation of blood vessels (vasculitis), usually the coronary arteries which supply blood to the heart

You should know that any of these complications can damage your child's heart. Inflammation of the coronary arteries can lead to weakening and bulging of the artery wall (aneurysm). Aneurysms increase the risk of blood clots forming and blocking the artery, which could lead to a heart attack or cause life-threatening internal bleeding.

It is important to know that for a small percentage of children who develop coronary artery problems, Kawasaki disease is fatal, even with treatment.

What causes

The exact cause is still not known. Microorganisms and toxins have been suspected, but none has been identified to date. Kawasaki's disease is not felt to be a contagious illness. Genetic factors and the immune system seem to play roles in the disease, which is characterized by immune activation.

Prevention

Unfortunately, Kawasaki disease can't be prevented. However, most children who have the disease recover usually within weeks of getting signs and symptoms. Further problems are rare.

Treatment

Causes of Kawasaki disease can be serious health problems. So your child should take a treatment in a hospital, at least for the early part of treatment. The standard treatment during the disease's acute phase is high-dose aspirin and immune globulin. Immune globulin is a medicine that's injected into a vein.

Children who receive these treatments improve greatly within 24 hours. Fever remains for a small number of children. These children may need a second round of immune globulin.

At the beginning of treatment, your child should receive high doses of aspirin. As soon as your child’s fever goes away, a low dose of aspirin is given. The low dose helps prevent blood clots, which can form in the inflamed small arteries.

Most children treated for Kawasaki disease fully recover from the acute phase and don't need any further treatment. They should follow a healthy diet and adopt healthy lifestyle habits. Taking these steps can help lower the risk of future heart disease. Following a healthy lifestyle is advised for all children, not just those who have Kawasaki disease.

Children who have had immune globulin should wait 11 months before having the measles and chicken pox vaccines. Immune globulin can prevent those vaccines from working