Kawasaki's Disease Demystified: Causes, Symptoms, Diagnosis and Treatment

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.