Kawasaki disease is an acute febrile vasculitis that can, if left untreated, lead to potentially life-threatening cardiovascular issues. It is the most common cause of acquired heart disease in children in developed nations.
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Kawasaki disease often weakens parts of the coronary artery walls and can result in aneurysms. Blood clots can form in the weakened parts and cause a heart attack. In some patients, the disease causes myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the sac surrounding the heart).
Cases of Kawasaki disease occur all over the world, but affects mainly Asian populations, particularly Japanese. Boys are affected more often than girls.
SYMPTOMS
Prolonged fever is the first symptom that appears in a case of Kawasaki disease. The fever usually has a temperature over 38°C and lasts at least five days, with antipyretics such as paracetamol having no affect.
In addition to fever, there are five diagnostic criteria associated with the disease:
-Bilateral conjunctivitis
-Cervical lymphadenopathy (enlarged lymph nodes)
-A rash (in the form of small bumpy spots located on the bottom)
-Oropharyngeal ailments (erythema of the lips, dryness, cracks, bleeding, “strawberry tongue”)
-Foot and hand injuries (erythema of the palms, edema)
It has also been observed that children with Kawasaki disease are usually irritable and in poor condition overall.
Cardiac complications occur in 25-30% untreated patients.
CAUSES
The exact causes of Kawasaki disease are unknown. Researchers, however, tend to lean towards the hypothesis of viral infection as seasonal peaks of the disease have been observed. In addition, the fact that there are few cases that occur after infancy suggests that the infectious agent of Kawasaki disease is immunizing.
TREATMENT
When a diagnosis of Kawasaki Disease has been made, the patient must be immediately hospitalized and treated quickly. Treatment is based on the combination of two drugs: aspirin and a dose of intravenous immunoglobulin. These medications help to reduce fever, rashes, and inflammation, and prevent the formation of blood clots. The majority of patients respond well to treatment if it is done early.
Patients with Kawasaki Disease should also be given a cardiac ultrasound and electrocardiogram so that physicians can detect heart rhythm disorders, ventricular dysfunctions, dilations, and coronary aneurysms, if any.
