Kawasaki Disease

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2008-02-20T04:32:00.001-08:00

Kawasaki Disease was named after a Japanese paediatrician Dr. Tomisaku Kawasaki, who first described it in 1967. It is most common among children of Japanese and Korean descent, but the illness can affect all ethnic groups.There is no simple test for Kawasaki disease. The diagnosis is made by recognising the symptoms and signs of Kawasaki disease in a child who has a persistent fever with no other likely explanation. Blood tests may also help. An echocardiogram is performed to look for any changes in the coronary arteries.

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2008-02-20T03:49:00.001-08:00

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2008-02-18T05:59:00.000-08:00

Kawasaki Disease (KD) is an illness that involves the skin, mouth, and lymph nodes, and typically affects children who are under the age of 5. The cause of Kawasaki Disease is unknown, but if the symptoms are recognized early, kids with the disease can fully recover within a few days. If it goes untreated, it can lead to serious complications that can involve the heart.Kawasaki disease occurs in 19 out of every 100,000 kids in the United States.

Kawasaki Disease was named after a Japanese paediatrician Dr. Tomisaku Kawasaki, who first described it in 1967. It is most common among children of Japanese and Korean descent, but the illness can affect all ethnic groups.There is no simple test for Kawasaki disease. The diagnosis is made by recognising the symptoms and signs of Kawasaki disease in a child who has a persistent fever with no other likely explanation. Blood tests may also help. An echocardiogram is performed to look for any changes in the coronary arteries.

Causes

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The cause of Kawasaki disease is not fully understood. The symptoms of the disease are characteristic of a virus. However, Kawasaki disease is not contagious, which means it is unlikely to be caused by a virus alone.

Some research suggests that Kawasaki disease is caused by an unusual, or abnormal, reaction to a common virus, that most people are unaffected by. Other theories suggest that it could be an autoimmune disorder (when the body's immune system attacks its own tissue), or a reaction to chemicals or pollutants. However, no theory has yet to be conclusively proven.

Key points to remember

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SYMPTOMS

Disease starts with persistent fever with no other likely explanation

Fever more than 100 degrees that is not responding to Paracetamol

Strawberry colored tongue & lips

Dilated eyes

Rashes on body as measiles

TREATMENT

It is treated with Intravenous Gammaglobulin (IVIG)

Medication for a certain period with Aspirin tablets

Strict follow-up is required by your Paediatric Cardiologist. (Echocardiogram )

Most children with Kawasaki disease recover completely with proper therapy.

Care at home

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A small percentage of children develop problems with either the heart muscle or the coronary arteries. The heart problem appears in the first phase of the illness and this is why the initial echocardiogram is performed. If the test is negative, then it is very unlikely that problems will develop later but a further check test is usually performed at 6-8 weeks.

A small percentage of children have recurrence of the symptoms weeks or months later - if this happens consult your paediatrician.
If your child has Kawasaki disease he will need to be followed up long-term by his GP and a paediatrician.

If your child is due a routine MMR (measles, mumps, rubella) immunisation - this should be delayed until 3 months after the gammaglobulin treatment.
The vast majority of children with Kawasaki disease recover and live normal lives

2008-01-29T06:41:00.000-08:00

Kawasaki Disease is an illness that involves the skin, mouth, and lymph nodes, and typically affects children who are under the age of 5. The cause of Kawasaki Disease is unknown, but if the symptoms are recognized early, kids with the disease can fully recover within a few days. If it goes untreated, it can lead to serious complications that can involve the heart.
Kawasaki disease occurs in 19 out of every 100,000 kids in the United States.Kawasaki Disease was named after a Japanese paediatrician Thomasaku Kawasaki, who first described it in 1967. It is most common among children of Japanese and Korean descent, but the illness can affect all ethnic groups.

There is no simple test for Kawasaki disease. The diagnosis is made by recognising the symptoms and signs of Kawasaki disease in a child who has a persistent fever with no other likely explanation. Blood tests may also help. An echocardiogram is performed to look for any changes in the coronary arteries.

Treatment

2008-01-29T06:12:00.001-08:00

Treatment should begin as soon as possible, ideally within 10 days of when the fever first begins. Usually, a child is treated with intravenous doses of gamma globulin (purified antibodies), an ingredient of blood that helps the child's body fight off infection. The child may also be given a high-dose of aspirin to reduce the risk of heart problems.

Diagnosis

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There is no one test to detect Kawasaki disease, so a doctor typically diagnoses it by evaluating the child's symptoms and ruling out other conditions.
Typically, a child who is diagnosed with this illness will have a fever lasting 5 or more days and at least 4 of the following symptoms:

redness in both eyes
changes around the lips, tongue, or mouth
changes in the fingers and toes, such as swelling, discoloration, or peeling
a rash in the trunk or genital area
a large swollen lymph node in the neck
red, swollen palms of hands and soles of feet

If Kawasaki disease is suspected, a doctor may order tests to monitor the child's heart function, which can include an echocardiogram, and other tests of heart function. A doctor may also take blood and urine samples to rule out other conditions, such asscarlet fever, measles,Rocky Moutain Spotted Fever, Stevens-Johnson syndrome,juvenile rheumatoid arthritis, and an allergic drug reaction.

Complications

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Doctors can manage the symptoms of Kawasaki disease if they catch it early. The symptoms typically disappear within just two days of when treatment begins. Usually, if Kawasaki disease is treated within 10 days of when the first symptoms begin, no heart problems develop.

But if the illness goes untreated (time period can vary, but likely for 10-14 days and sooner in young infants), it can lead to more serious complications that involve the child's heart. The coronary arteries are most often affected. Part of a coronary wall can be weakened and balloon (bulge out) in an aneurysm. A blood clot can form in this weakened area and block the artery, sometimes leading to a heart attack. The aneurysm can also burst, but this rarely happens.
Other changes include inflammation of the heart muscle (myocarditis) or the sac surrounding the heart (pericarditis). Arrhythmias (abnormal heart rhythms) or abnormal functioning of some heart valves also can occur.

Usually all the heart problems go away in five or six weeks, and there's no lasting damage. Sometimes coronary artery damage persists, however.

Symptoms

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The symptoms of Kawasaki Disease typically appear in phases.
The first phase, which can last for up to 2 weeks, usually involves a persistent fever that is higher than 104 degrees Fahrenheit (39 degrees Celsius), and lasts for at least 5 days. The other symptoms that typically develop include:

*severe redness in the eyes
*a rash on the child's stomach, chest, and genitals
*red, dry, cracked lips
*swollen tongue with a white coating and big red bumps
*sore, irritated throat
*swollen palms of the hands and soles of the
feet a purple-red color
*swollen lymph nodes

During the second phase of the illness, which usually begins within two weeks of when the fever first begins, the skin on the child's hands and feet may begin to peel in large pieces. The child may also experience joint pain,diarrhea,vomiting, or abdominal pain.KD is more common in males than in females, with a male-to-female ratio of 1.3-1.6:1. Arthritis appears more common in girls than in boys