Kawasaki disease

Kawasaki disease is a rare condition that mainly affects children under the age of five. The disease was first described in 1967 by a Japanese pediatrician, Kawasaki. Kawasaki described children with fever, rash and other symptoms. Most children recover quickly, although the disease can cause various heart complications. Early diagnosis and treatment is the most important thing for this disease.

What are the symptoms?

Fever lasting 5 days or longer is common with this disease. Furthermore these symptoms:

  • Red eyes.
  • Change in the mouth. Such as a red throat or tongue, or dry and cracked lips.
  • One or more lymph nodes in the neck swell.
  • Changes in the hands or feet, such as swelling or red hands/feet. In addition, the skin may flake.
  • In some cases diarrhea, jaundice, abdominal pain, vomiting,

The diagnosis is based on the symptoms except the last symptom. There is no test to confirm the disease, but tests can be done to rule out other childhood diseases (such as measles and scarlet fever).

What is the cause?

It is not yet clear what Kawasaki’s cause is. The symptoms indicate an infection, although it is not contagious. Hypersensitivity or an abnormal immune response, or an infection (virus or bacteria) can lead to an inflammatory process. This can lead to inflammation and damage to the blood vessels.

Is the disease hereditary?

The disease is not hereditary, although there is a genetic susceptibility. For example, parents of children with Kawasaki disease are more likely to have had the condition themselves. Siblings of children with Kawasaki disease also have an increased risk of developing the condition. A child can contract the disease twice, but this is very rare.

How does the disease develop?

First of all, there is a long-lasting fever. After that, it is often the case that the symptoms appear one after the other. These symptoms are listed at the top of the article. Usually the disease lasts about 10 days, although complications can develop. The severity of the illness varies from child to child. The child may be very ill for 10 days while the other child appears to have a mild infection. Any child with the above symptoms should be admitted to hospital to prevent possible heart complications. A heart scan is usually made for this. If complications occur, they usually develop a week after symptoms.

What does the treatment consist of?

The treatment usually consists of two parts:

  • Aspirin, this is used to reduce inflammation in the coronary arteries (veins that run to the heart).
  • Gammaglobulins. This is an antibody obtained from human blood. It is given by an infusion into the bloodstream. Gammaglobulins would especially help to prevent a complication in the heart.

Without treatment, approximately 20 in 100 children will develop a complication, with treatment this is reduced to 5 in 100 children.

What are the possible complications?

Inflammation may develop in the coronary arteries. This may be swelling of part of an artery, which is called an aneurysm. A coronary aneurysm usually does not cause any symptoms. Over time it often goes away and the artery returns to normal. However, the wall of an aneurysm weakens and becomes abnormal. Serious problems can develop in some children with an aneurysm. The most serious is that a thrombosis (clot) develops in the aneurysm. A heart attack can also occur. About 1 in 100 children with Kawasaki disease die from heart problems. An aneurysm can be detected by a heart scan (an echocardiogram). Treatment within 10 days prevents this complication very often. This is why it is important to diagnose and treat Kawasaki disease early.

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