by Kimberly Allen RN
Kawasaki disease also known as Kawasaki syndrome was originally called mucocutaneous lymph node syndrome, which in truth is a more accurate description of the disorder. Kawasaki disease usually affects young children, primarily those under 5 years of age. It usually affects boys more often than girls. It affects all ethnic groups but is more prevalent in people of Japanese or Korean descent. Kawasaki disease is the most frequently diagnosed pediatric vascular disorder in the world. Though Japan has the highest incidence rate it has been increasing in the US in recent years with approximately 4,000 new cases diagnosed each year in the US. Some experts believe that there may be a early winter through spring seasonality to the disease as there have been reports of community wide outbreaks.
Kawasaki disease is defined as an autoimmune disorder primarily because no one knows what causes it. There have been numerous theories involving viruses, bacteria, genetics and environmental factors but no one has been able to prove any of them. It is a disorder that causes inflammation in the walls of certain arteries, primarily the small and medium arteries through out your body. This would include the arteries that supply the heart with fresh oxygenated blood as well as many other organs.
The symptoms of Kawasaki disease occur in phases. In the first phase the child will have a high fever, frequently over 104F, that lasts 1-2 weeks. They also may have very red eyes, a rash over their chest and back as well as swollen and red palms and soles of their feet. Others in the first phase including dry cracked and red lips with a severely swollen and red tongue as well as swollen lymph nodes, especially in the neck. The child is also quite irritable. In the second phase your child usually complains of joint and abdominal pain accompanied by vomiting and diarrhea. You may also notice the skin on the hands and feet start peeling especially on the ends of the fingers and toes. In the third phase, unless your child has developed complications, the symptoms begin to slowly disappear, however, it can take up to 8 weeks before your child returns to his/her previous level of activity.
The most common complication of Kawasaki disease is acquired heart disease. This would include inflammation of the heart and the blood vessels of the heart as well as heart valve problems, especially the mitral valve and dysrhythmias Any of those heart complications can cause damage to your child’s heart including increasing their risk for aneurysms and blood clots which can in turn lead to more serious problems including heart attack and stroke as well as internal bleeding.
The initial goal of treatment is to reduce the fever and inflammation as well as prevent complications especially damage to the heart. Kawasaki disease is probably the only time aspirin is given to children. High doses of aspirin are given to reduce the fever as well as inflammation and joint pain. Gamma globulin is an immune protein that can decrease the risk of complications with the coronary arteries that can be given intravenously. Treatment for Kawasaki disease is always initiated in th the hospital because the potential for serious complications is so high that your child will need to be monitored closely. The Dr will usually monitor your child’s heart by doing an electrocardiogram as well as an ultrasound of the heart. Approximately 25% of the children with Kawasaki disease develop coronary aneurysms and these tests can confirm whether or not your child has developed any of these problems and provide the Dr with information needed to treat your child.
Though most children recover fully from Kawasaki disease with in a month or two it’s important to be aware of the potential complications as well as the potential for long term damage. Always give the Dr a complete and accurate history of your child’s symptoms for the best outcome.
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.