Kawasaki disease (KD) or mucocutaneous lymph node syndrome is a disease that causes inflammation in arteries, veins, and capillaries. It also affects your lymph nodes and causes symptoms in your nose, mouth, and throat. It is the most common cause of heart disease in children.
The Kawasaki Disease Foundation (KDF) states that more than 4,200 children in the United States are affected each year. CD is also more common in boys than girls and children of Asia-Pacific Island descent. However, KD can affect children and young people of all racial and ethnic backgrounds.
In most cases, children recover without any serious problems within a few days of treatment. Recurrences are rare. Left untreated, KD can lead to serious heart disease.
What are the symptoms of Kawasaki disease?
Kawasaki disease symptoms and occurs in stages with its findings. The condition tends to occur in late winter and spring. In some Asian countries, KD cases peak in mid-summer.
Early symptoms that can last up to two weeks:
- high fever that lasts for five or more days
- rash on the trunk and groin
- bloodshot eyes
- bright red, swollen lips
- “Strawberry” language that looks bright and shiny with red spots
- swollen lymph nodes
- swollen hands and feet
- red palms and soles
Heart problems can also occur during this time.
Subsequent symptoms begin within two weeks after the fever. The skin on your child’s hands and feet may start to peel off and come off in layers. Some children may also develop temporary arthritis or joint pain.
Other signs and symptoms include:
- abdominal pain
- enlarged gallbladder
- temporary hearing loss
Call your doctor if your child is showing any of these symptoms. Children younger than 1 year old or older than 5 years old are more likely to have missing symptoms. These children account for 25 percent of KD cases at high risk of heart disease complications.
What causes Kawasaki disease?
The exact cause of Kawasaki disease is still unknown. Researchers speculate that a mix of genetic and environmental factors can cause KD. This may be because KD occurs during certain seasons and tends to affect children of Asian descent.
Kawasaki disease is most common in children, especially those of Asian descent. According to the KDF report, 75% of cases are children under 5 years old. Researchers don’t believe you can inherit the disease, but risk factors tend to increase in families. The siblings of someone with KD are 10 times more likely to get the disease.
How is Kawasaki disease diagnosed?
There is no specific test for Kawasaki disease. A pediatrician will take into account the child’s symptoms and rule out illnesses with similar symptoms such as:
- a bacterial infection that causes scarlet fever, chills, and sore throat
- Juvenile rheumatoid arthritis, a chronic disease that causes joint pain and inflammation
- toxic shock syndrome
- idiopathic juvenile arthritis
- juvenile mercury poisoning
- medical reaction
- Rocky Mountain spotted fever, a tick-borne disease
A pediatrician may order additional tests to check how the disease is affecting the heart. These can include:
- Echocardiograph: Echocardiograph is a painless procedure that uses sound waves to create pictures of the heart and its arteries. This test may need to be repeated to show how Kawasaki disease has affected the heart over time.
- Blood tests: Blood tests may be ordered to rule out other diseases. There may be a high white blood cell count, low red blood cell count, and inflammation in KD.
- Chest X-ray. A chest X-ray creates black and white images of the heart and lungs. A doctor may order this test to look for signs of heart failure and inflammation.
- Electrocardiogram: An electrocardiogram, or EKG, records the electrical activity of the heart. Irregularities in the ECG may indicate that the heart is affected by KD.
Kawasaki disease should be considered a possibility in any infant or child whose fever lasts for more than five days. This is especially true if they show other classic symptoms of the disease, such as peeling of the skin.
How is Kawasaki disease treated?
Children diagnosed with KD are treated immediately to prevent heart damage.
First-line treatment for KD includes infusion of antibodies (intravenous immunoglobulin) for 12 hours within 10 days after fever, and intake of aspirin at a sufficient daily dose for the next four days. The child may need to continue taking lower doses of aspirin for six to eight weeks after the fever resolves to prevent blood clots from forming.
One study also found that the addition of prednisolone significantly reduced potential heart damage. However, this has not yet been tested in other populations.
Timing is important to prevent serious heart problems. Studies may also show a higher resistance to treatment when given before the fifth day of fever. Approximately 11 to 23 percent of children with KD will show a resistance.
Some children may require longer treatment times to prevent a blocked artery or heart attack. In these cases, treatment includes daily doses of antiplatelet aspirin until you have a normal ECG. It can take six to eight weeks for coronary artery abnormalities to return.
What are the long-term consequences of Kawasaki disease?
There are four possible outcomes for someone with KD:
- With early diagnosis and treatment, you will make a full recovery without heart problems.
- You develop coronary artery problems. In 60 percent of these cases, patients can reduce these concerns within a year.
- You experience prolonged heart problems that require long-term treatment.
- Recurrence of KD occurs in only 3 percent of cases.
When diagnosed and treated early, KD has a positive outcome.
KD is a disease that causes inflammation in your body, particularly blood vessels and lymph nodes. It mainly affects children under the age of 5, but that doesn’t just mean that age group will get sick, we can all get this disease.
If your child is showing any of these symptoms, talk to your doctor. Symptoms may appear incomplete in some children, but KD can cause serious heart problems if left untreated. Approximately 25 percent of cases of heart disease are due to misdiagnosis and delayed treatment.
There is no specific diagnostic test for KD. Your doctor will look at your children’s symptoms and prepare tests to rule out other conditions. Timely treatment can significantly increase the positive outcome for children with KD.