Free Medical Articles

WHAT  IS  KAWASAKI  DISEASE? 

 

Kawasaki disease, or mucocutaneous lymph node syndrome as it is also known, is a rather unusual illness that mainly affects pre-school children.

 

• Kawasaki disease was first identified in Japan in1967. This rare condition or causes inflammation of the blood vessels, which can lead to a wide range of symptoms. 
• Although most children recover from Kawasaki disease, there may be long-term problems because of damage to the heart. 
• No one knows what causes Kawasaki disease. Many Doctors Think it must be due to a virus, or another type of infectious microbe, because the disease can occur in out breaks and it only affect children who have not had time to become immune to it. 
• However, there seem to be other factors at work; Japanese children are much more likely to get Kawasaki disease, and it rarely seems to spread from person to person. 

A swollen tongue and cracked lips are symptoms of Kawasaki disease, as well as a rash, conjunctivitis and fever. A child must have five or more specific symptoms to be diagnosed.

 

Who is affected?

 

Kawasaki disease is fairly uncommon. However, it is likely that more children do get the disease but are never diagnosed

 

• Kawasaki disease is an illness that usually affects pre-school children, although older children do sometimes suffer from it. 
• Four out of five cases of Kawasaki disease occur in children who are less than five years old. 
• Toddlers, from one to two years, are the most likely to be affected. 
• Kawasaki disease is harder to diagnose in very young children and they are, unfortunately, more likely to have complications involving the heart. 
• Boys are more commonly affected than girls. The reason for this is unknown. 
• Although children from all racial groups may get Kawasaki disease, it is up to ten times more common in Japanese children (one in every 1000. 

Kawasaki disease occurs most commonly in children under five and affects more boys than girls. It is most prevalent in Japanese children.

 

The illness must be diagnosed on the basis of the child's symptoms. He must have five of the following symptoms:

 

A fever that persists for five days or more. 

Conjunctivitis - both eyes may be red and sore. 

Swelling, redness and then peeling of the hands and feet.

A skin rash appearing anywhere on the body. 

A swollen red strawberry tongue and cracked lips. 

Enlarged lymph nodes in the neck. 

NOTE: other symptoms may mimic measles, or include distress, painful joints, diarrhea, vomiting and abdominal pain.

 

Effects on the heart

 

Kawasaki disease is the most common cause of heart disease acquired by children in developed countries today. If Kawasaki disease is suspected, a special investigation of the heart - called an echocardiogram - will be performed to check for damage.

 

• Although most children who get Kawasaki disease recover fully, about one in five may have further problems due to damage to the heart or its blood vessels. 
• These effects may occur during the first, acute, illness or may happen some time afterwards. 
• The heart muscle or membrane around the heart may become acutely inflamed, causing breathlessness and swelling due to heart failure. 
• There may be damage to the coronary arteries, the blood vessels that supply the heart. These vessels may become wider due to weakening of the walls, and areas of ballooning known as aneurysms may form. In a few cases, this leads to a blood clot being formed, which may cause a fatal heart attack. 
• There is a small risk that months or even years after the acute illness, the coronary arteries will become narrowed. This reduces the amount of blood (and therefore oxygen) that can reach the heart muscle, leading to angina and possible heart attack. 
• Death, when it occurs, usually does so suddenly between the 10th and 28th day of illness. It seldom occurs in children over two years of age. 

If a child has Kawasaki disease, an echocardiogram will be performed to check for heart damage.

 

What treatment is available

 

Even though doctors do, not know what causes Kawasaki disease, there are some medicines that can help.

 

• Treatment for Kawasaki disease is aimed mainly at trying to prevent damage to the heart and coronary arteries. 
• Intravenous gamma globulin may be given through a, vein. This medicine contains proteins from human blood that help with immunity. If given within 10 days of the start of the illness, it can help to reduce the risk of heart damage. 
• Although we think of aspirin as a painkiller, it has many useful actions. In Kawasaki disease it helps to reduce fever and inflammation, but also helps to thin the blood in order to prevent clotting. If there is damage to the coronary arteries, low-dose aspirin may be continued for a long time. 
• Aspirin is not normally used children under 12 years, but in the case of Kawasaki disease its use is felt to be justified. 
• A specialist in child heart conditions, a paediatric cardiologist, will ascertain if the heart has been damaged. 
• New studies are being made all the time to see if better ways can be found to treat this potentially serious disease. One recent study showed that taking a combination of heparin, a blood thinning medicine, and regular exercise, may help the damaged blood vessels to repair themselves. 

Although aspirin is not usually given to young children, it is used to treat Kawasaki disease because; it helps to thin the blood, preventing dotting.

 

Difficulty in diagnosis

 

As Kawasaki disease is so unusual, many doctors have never seen a case before. This

can make it much harder to diagnose than the more common viral illnesses that Kawasaki disease resembles.

 

• Diagnosis is particularly difficult in the case of children who may not have distinctive symptoms. Some children, particularly very young ones, have what is called an atypical illness, where only a few of the symptoms of Kawasaki disease are present. In these cases the doctor may not recognize the disease. 
• The Kawasaki support groups, together with the medical experts, are trying to raise awareness of this disease among family doctors and parents so that affected children will be diagnosed sooner. Earlier diagnosis will lead to earlier treatment, which in turn should reduce the risk of heart damage in these children. 

For  More  Information:  Please  consult  your  physician  on  your  next  visit.