Kawasaki Disease

Kawasaki disease (KD), also known as Kawasaki syndrome, is a serious illness characterized by inflammation of blood vessels throughout the body that primarily affects young children and infants.  Kawasaki disease is the leading cause of acquired heart disease in children.  Although about 80 percent of patients are under five years of age, older children and teenagers can also get KD, but this is uncommon.  KD is more common in boys than girls, and the majority of cases are diagnosed in the winter and early spring. It is not contagious.

The disease is named after Tomisaku Kawasaki, a Japanese pediatrician who first described the illness in the medical literature in 1967.  Although it is more prevalent among children of Asian and Pacific Island descent, KD affects people of all racial and ethnic groups. It is estimated that more than 4,200 children are diagnosed with Kawasaki Disease in the U.S. each year. The cause of KD is unknown, although an agent, like a virus, is suspected.  There is no currently accepted scientific evidence that KD is caused by carpet cleaning or chemical exposure.

How is it treated?
Treatment for Kawasaki disease starts in the hospital. It may include:

Immunoglobulin (IVIG) medicine. This is given through a vein (intravenous, or IV) to reduce inflammation of the blood vessels.
Aspirin to help pain and fever and to lower the risk of blood clots.
Aspirin therapy is often continued at home. Because of the risk of Reye syndrome, do not give aspirin to your child without talking to your doctor. If your child is exposed to or develops chickenpox or flu (influenza) while taking aspirin, talk with your doctor right away.

How serious is Kawasaki disease?
Most children with Kawasaki disease get better and have no long-term problems. Treatment is important because it shortens the illness and reduces the chances of problems.

Some children who are not treated will have damage to the coronary arteries. An artery may get too large and form an aneurysm. Or the arteries may narrow or develop blood clots. A child who has damaged coronary arteries may be more likely to have a heart attack as a young adult.

Kawasaki Disease is characterized by an inflammation of the blood vessels throughout the body.  There is no specific test for KD; doctors make a clinical diagnosis based on a collection of symptoms and physical findings.  Early symptoms of KD include:
Fever that lasts for five or more days   
Rash, often worse in the groin area   
Red bloodshot eyes, without drainage or crusting   
Bright red, swollen, cracked lips, “strawberry” tongue, which appears with shiny bright red spots after the top coating sloughs off  
Swollen hands and feet and redness of the palms and soles of the feet   
Swollen lymph nodes in the neck
Understandably, children with these symptoms are extremely uncomfortable and irritable. Any parent whose child has persistent fever and any of these symptoms should take him or her to the doctor immediately.

Without treatment, about 25% of children develop heart disease involving the coronary arteries.  Timely diagnosis and treatment (which usually includes intravenous gamma globulin) is highly effective in preventing coronary complications.  Doctors continue to study the long-term outcome of children who do not appear to have coronary involvement.  Other kinds of longer-term consequences (e.g., non-coronary) are extremely rare.  There is no evidence that links KD with autism or a seizure disorder. A very small number of KD children might have a seizure in the early acute stage of KD when there are very high fevers, but there is no on-going or long term seizure prone condition.
 
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