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.
The following list of medications are in some way related to or used in the treatment of this condition.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.