by Kimberly Allen, RN
Kawasaki disease is currently the most commonly diagnosed pediatric vasculitis worldwide. Although the highest incidence of Kawasaki disease is in Japan the incidence in the US has been increasing with as many as 4,000 new cases diagnosed every year. At least 80% of those diagnosed with Kawasaki disease are under 5 years of age. Kawasaki disease affects boys more often than girls and people of Asian descent, particularly Japanese or Korean, are affected more often than other races.
Kawasaki disease affects the small and medium arteries through out the your child’s body as well as the skin, lymph nodes and mucous membranes of their mouth, nose throat. It causes the walls of the small and medium, including the coronary arteries to become inflamed. Although no one knows the cause of Kawasaki disease many experts believe it may be linked to bacterial or viral infections as well as environmental factors. However, they have been unable to prove it. They also believe there may be certain genes that increase a child’s susceptibility to the disease.
The symptoms of Kawasaki disease manifest in phases. In the first phase your child will develop a persistent high fever which can be above 104F/39C that can last as long as 2 weeks. They will usually have severely red eyes and dry, cracked and red lips with a “strawberry” tongue. Other symptoms you may see in the first phase include a rash on your child’s upper body including the genital area, swollen lymph nodes and red, swollen skin on their palms and the soles of their feet as well as irritability. In the second phase you may notice the skin on your child’s hands and feet peeling as well as vomiting and diarrhea. Unless your child has developed complications the symptoms gradually begin to disappear in the third phase.
There is no specific test currently available to diagnose Kawasaki disease. Kawasaki disease can be difficult to diagnose as it resembles numerous other conditions including scarlet fever, measles and certain tick borne diseases like Rocky Mountain spotted fever as well as juvenile rheumatoid arthritis, toxic shock syndrome and Stevens – Johnson syndrome. This means your doctor must rely on the symptoms your child demonstrates as well as urine and blood tests to rule out other diseases. Your doctor may also order an electrocardiogram and an echocardiogram to assess your child’s cardiac function.
Without treatment Kawasaki disease lasts around 2 weeks, however,. cardiac complications can manifest later and last longer, they can also be serious. If you suspect your child may have Kawasaki disease it’s important to contact your Dr immediately. The sooner treatment is initiated the better the chances of preventing long term cardiac problems. Treatment for Kawasaki disease begins in a hospital setting with an infusion of gamma globulin which is an immune protein that can reduce your child’s risk of developing coronary artery problems. Your child will also be started on an aspirin regimen to help prevent blood clots as well as reduce the fever, inflammation and pain. however, because aspirin can cause Reyes syndrome aspirin should only be given under supervision of your doctor. Should your child be exposed to certain viral infections like the flu or chicken pox while taking aspirin contact your doctor immediately. Some children may need to take a low-dose of aspirin for 6 to 8 weeks, even longer if he/she develops a coronary aneurysm. Your child may be fussy and tired and his/her skin may be very dry for 4 to 6 weeks. It’s important to not allow your child to become over tired and keep him/her hydrated. Using lotion can help keep your child’s skin moist. It can take several weeks before your child feels totally well, however, most children with Kawasaki disease do recover without long term problems. Getting treatment early shortens the time your child is ill as well as reduces the chances of developing heart problems that can last a long time.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.