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Medications for Kawasaki Disease (Mucocutaneous Lymph Node Syndrome)

About Kawasaki Disease: 


Kawasaki disease is a rare illness that mainly affects young children under the age of 5 years old, which causes swelling and inflammation within the walls of medium-sized arteries especially the heart arteries.  Symptoms are long lasting fever, swollen glands in the neck, skin rashes, skin peeling, red eyes, and inflammation of the lips mouth and tongue. There is no specific test or definite symptom to diagnose Kawasaki disease, so instead Kawasaki disease is diagnosed by the child having a combination of the symptoms, and results from blood tests, ultrasound of the heart and by excluding other conditions that have similar symptoms.

Symptoms and Stages of Kawasaki disease

Kawasaki disease can last up to 6 to 9 weeks and symptoms change depending on which stage of the illness the child is in.

Early stage during the first week to 10 days:

  • fever over 102.2F (39C) which lasts at least 5 days but can last up to 25 days and is often unchanged with treatment with acetaminophen or ibuprofen
  • extreme irritability
  • swollen lips with vertical cracking and bleeding
  • inside the mouth is red and the tongue is swollen and red
  • red eyes without redness around the iris and without any discharge
  • rash on the trunk which may spread to arms, legs, face and around the nappy area
  • red and swollen hands and feet
  • swollen glands in the neck
  • inflammation of the heart muscle (myocarditis)
  • inflammation at the BCG vaccination site


Later stage from 2 weeks to 8 weeks:

  • fever, rash and swollen lymph nodes have resolved
  • irritability and red eyes persist
  • skin on fingers, toes and around the genital and anal area starts peeling off in thick layers
  • joint pain
  • thrombocytosis occurs, which is when there are too many platelets in the blood and this increases the chance of clots, stroke and heart attacks
  • aneurysms may develop at this stage and there is an increased risk of sudden death.  An aneurysm is a weakening of an artery wall that creates a bulge of the artery, it may rupture or burst which can be fatal.

What is the cause of Kawasaki disease?
The cause of Kawasaki disease is currently unknown but is thought occur after an infection that triggers an autoimmune response. This means that the infection has activated the immune system but for some reason there is an abnormal immune response and it causes damage to parts of the body.

Who gets Kawasaki disease?
Some people are more likely to get Kawasaki disease

  •  usually it affects children under 5 years old.
  • ratio of boys to girls is 1.5 : 1
  • Japanese and Korean people are thought to be more genetically susceptible to Kawasaki disease.

Complications of Kawasaki disease.

Cardiovascular:

  • heart disease acquired in childhood
  • coronary artery aneurysms
  • transient coronary artery dilation
  • myocardial infarct
  • rupture of a large coronary artery aneurysm

Other complications:

  • gastrointestinal complications
  • eye changes
  • neurological complications
  • death

Diagnosis
Diagnosis of Kawasaki disease is based on the child's symptoms and how they progress. Blood tests and heart ultrasounds are also done.  As the symptoms can be similar to other conditions it is important to exclude any other conditions.

Treatment of Kawasaki Disease
It is important to start treatment for Kawasaki disease as soon as possible, and treatment often starts in hospital.

  • Aspirin is used to treat inflammation, decrease pain and reduce fever.  Aspirin is not usually given to children so should only be given under the supervision of a doctor.
  • Gamma globulin is an immune protein that is give intravenously to reduce the future risk of coronary artery problems


Pediatric Multisystem Inflammatory Syndrome
Pediatric Multisystem Inflammatory Syndrome (PMIS) symptoms are systemic inflammation, persistent fever, conjunctivitis, fever, rash and diarrhea so these symptoms are similar to Kawasaki disease. PMIS has possible links to the COVID-19 outbreak of 2020.  As the SARS-CoV-2 infection and the illness COVID-19 are recent developments, information on how PMIS relates to Kawasaki disease is currently unknown.

Drugs Used to Treat Kawasaki Disease

The following list of medications are in some way related to, or used in the treatment of this condition.

Drug name Rx / OTC Pregnancy CSA Alcohol Reviews Rating Popularity
aspirin N N X Add review
0.0

Generic name: aspirin systemic

Brand names:  Easprin, Bayer Aspirin, Arthritis Pain, Halfprin, Aspergum, Bufferin, Ecotrin, Fasprin, Genacote, Aspiritab, Aspirtab, Ecpirin, Entercote, Norwich Aspirin, Bayer Aspirin Extra Strength Plus …show all

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

immune globulin intravenous C N Add review
0.0

Generic name: immune globulin intravenous systemic

Brand name:  Gammagard S / D

Drug class: immune globulins

For consumers: dosage, interactions,

Easprin N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

infliximab Off Label B N Add review
0.0

Generic name: infliximab systemic

Drug class: antirheumatics, TNF alfa inhibitors

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph

Off Label: Yes

Bayer Aspirin N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Arthritis Pain N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Halfprin N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Aspergum N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Bufferin N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Ecotrin N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Fasprin N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Genacote N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Aspiritab N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Aspirtab N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Ecpirin N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Entercote N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Norwich Aspirin N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Bayer Aspirin Extra Strength Plus N N X Add review
0.0

Generic name: aspirin systemic

Drug class: salicylates, platelet aggregation inhibitors

For consumers: dosage, interactions, side effects

Gammagard S / D C N Add review
0.0

Generic name: immune globulin intravenous systemic

Drug class: immune globulins

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Learn more about Kawasaki Disease (Mucocutaneous Lymph Node Syndrome)

IBM Watson Micromedex

Mayo Clinic Reference

Legend

Rx Prescription Only
OTC Over the Counter
Rx/OTC Prescription or Over the Counter
Off Label This medication may not be approved by the FDA for the treatment of this condition.
Pregnancy Category
A Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
N Is not subject to the Controlled Substances Act.
1 Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2 Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3 Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4 Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5 Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X Interacts with Alcohol.

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