What is Kawasaki’s Disease?
Kawasaki's disease, also known as Kawasaki Syndrome is a rare but serious condition that affects mainly children under 5
years of age. It is a form of vasculitis, which means inflammation of the blood
vessels. It mainly affects small to medium-sized arteries that carry
oxygen-rich blood to the heart and other parts of the body. The inflammation
can damage the walls of these arteries and cause them to bulge or narrow, which
can affect blood flow and increase the risk of blood clots. This can lead to
serious complications such as abnormal dilations of the heart arteries and
myocarditis inflammation of the heart muscle.
Kawasaki disease is also known as
mucocutaneous lymph node syndrome, because it causes swelling of the lymph
nodes (glands that filter germs and other substances from the body) and mucous
membranes (the moist linings of the mouth, nose, eyes, and throat).
Who gets Kawasaki disease?
Kawasaki disease mainly affects children under
5 years old, especially those between 6 months and 2 years old. It is more
common in boys than girls, and in children of Asian or Pacific Islander
descent. However, it can affect children of any race or ethnicity.
Cause of Kawasaki’s Disease
The exact cause of Kawasaki disease is
unknown. It is not contagious, which means it does not spread from person to
person. Some experts think that it may be triggered by an infection with a
bacteria or virus that causes an abnormal immune system response in children
who are genetically predisposed. However, no specific infectious agent has been
identified as the cause of KD. Other factors such as environmental exposures or
genetic mutations may also play a role.
Symptoms of Kawasaki’s Disease
The symptoms usually appear in phases and
include:
- A high fever that lasts for more than five days and does not respond to usual medications.
- A rash on the trunk or genitals, and sometimes on the face or limbs.
- Redness and swelling of the eyes, lips, tongue, hands, and feet.
- Enlarged lymph nodes in the neck.
- Irritability, abdominal pain, diarrhea, vomiting, and joint pain.
These symptoms may not occur at the same time
or in every child. So it is important to tell the doctor about symptoms that
might have appeared and gone away. Some children may have incomplete Kawasaki's
disease, which means they have fewer than four of the typical symptoms but
still have inflammation of the blood vessels and need treatment. These children
are still at risk of developing complications involving the heart arteries and
need prompt treatment.
Diagnosis of Kawasaki’s Disease
The diagnosis of Kawasaki's disease is based
on the clinical signs and symptoms, as there is no specific test for it.
However, some tests may help to rule out other conditions or to assess the
extent of inflammation and damage to the heart and other organs. These tests
may include:
- Blood tests to check for signs of infection, inflammation, anemia, and liver function.
- Urine tests to check for signs of kidney problems or urinary tract infection.
- Electrocardiogram (ECG) to measure the electrical activity of the heart and detect any abnormal rhythms or damage.
- Echocardiogram (ultrasound of the heart) to visualize the structure and function of the heart and its valves and to look for any aneurysms or clots in the coronary arteries.
- Chest X-ray to check for any lung problems or fluid accumulation around the heart.
Treatment of Kawasaki’s Disease
The treatment of Kawasaki's disease aims to
reduce inflammation, prevent complications, and relieve symptoms. The standard
treatment consists of:
- High doses of intravenous immunoglobulin (IVIG), which are antibodies derived from donated blood that help to modulate the immune system response and reduce inflammation.
- Aspirin (acetylsalicylic acid), which is an anti-inflammatory and antiplatelet drug that helps to prevent blood clots and reduce fever and pain. The dose of aspirin is gradually reduced after the fever subsides and discontinued after 6 to 8 weeks unless there are signs of coronary artery involvement.
- Other medications such as corticosteroids, anticoagulants, or immunosuppressants may be used in some cases if IVIG or aspirin are not effective or cause side effects.
The treatment should be started as soon as
possible, ideally within 10 days of the onset of symptoms, to reduce the risk
of long-term complications. Most children recover fully with treatment and have
no lasting problems. However, some children may develop coronary artery
aneurysms or other heart problems that require ongoing monitoring and treatment
by a cardiologist.
Complications of Kawasaki's Disease
With early and appropriate treatment, most
children with Kawasaki disease recover completely and have no long-term
problems. However, some children may develop complications in the form of
different heart problems.
Follow Up Visits to the Doctor
Children who have had Kawasaki disease need
regular follow-up visits with a pediatric cardiologist (a doctor who
specializes in children's heart problems) to monitor their heart health and
function. They may need additional tests such as echocardiograms or angiograms
(X-rays of the blood vessels) to check for any changes or abnormalities in
their coronary arteries. They may also need to take medications such as aspirin
or anticoagulants for a long time or indefinitely to prevent blood clots. They
may also need to avoid certain activities or sports that put stress on their
hearts.
Adopt a Healthy lifestyle
Children who have had Kawasaki disease should
also adopt a healthy lifestyle that includes:
- Eating a balanced diet that is low in saturated fat, cholesterol, salt, and sugar
- Getting regular physical activity that is appropriate for their age and condition
- Maintaining a healthy weight
- Avoiding smoking and exposure to secondhand smoke
- Getting regular vaccinations and preventive care
Conclusion
Kawasaki disease is a rare but serious
condition that affects children under 5 years old. It causes inflammation of
the blood vessels of the heart and other organs, which can lead to serious
complications. The cause of Kawasaki disease is unknown, but it may be
triggered by an infection in genetically susceptible children. The diagnosis is
based on clinical criteria of fever and other signs, and tests such as
echocardiogram may confirm it. The treatment consists of medications that can
reduce inflammation and prevent or minimize damage to the heart arteries. With
early and appropriate treatment, most children recover completely and have no
long-term problems. However, some children may develop complications that
require lifelong monitoring and care by a pediatric cardiologist.
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