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Kawasaki Disease

(Kawasaki Syndrome; Mucocutaneous Lymph Node Syndrome)

Definition

Kawasaki disease is an illness that affects young children. It causes irritation and swelling of the skin, mouth, and lymph nodes. More serious illness can also lead to swelling in the coronary arteries. These arteries, supply oxygen to the heart. The swelling can cause serious heart problems like a weakening of blood vessel walls ( aneurysm ) and heart attack.
The sooner Kawasaki disease is treated, the better the outcome. If you suspect your child has this condition, contact the doctor right away.
Coronary Arteries
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Causes

The cause of Kawasaki disease is unknown. Some believe it is an infectious agent like a virus. However, Kawasaki does not seem to be contagious. It does not spread through households like the flu.

Risk Factors

Kawasaki disease is most common in children less than five year old. It is very rare in adults. Children of Asian ethnicity also seem to be more likely to get Kawasaki disease.
Outbreaks of the disease are more common during the winter and early spring months.

Symptoms

These symptoms may be caused by a number of health conditions. Call your doctor if your child has these symptoms:
  • Early symptoms (in first 2 weeks) may include
    • High fever—lasting for at least five days and usually greater than 102°F (38.8°C)
    • Irritability
    • Conjunctivitis (also known as “pink eye”)—red or “bloodshot” whites of the eye
    • Rash
    • Soreness and swelling of the mouth, lips, and throat
    • Strawberry tongue—white/yellow coating and bright red bumps on tongue
    • Swollen hands and feet that may look red
    • Swollen lymph nodes (organs of the immune system) in the neck
  • Later symptoms (within 2 weeks of the start of fever) may include:
    • Peeling of skin on hands and feet
    • Joint problems
    • Diarrhea, vomiting, or abdominal pain

Diagnosis

There is no specific test to diagnose Kawasaki disease. Your doctor will ask about your child’s symptoms and medical history. A physical exam will also be done.
Your doctor will often be able to make a diagnosis based on your child's symptoms. Tests may be done to look for signs of inflammation or heart involvement. These tests may include:

Treatment

Kawasaki will go away on its own. However, treatment can help to limit the damage the illness does. Treatment is especially important to reduce risk of damage to the heart. About 25% of children who do not receive treatment will develop serious heart problems.
Talk with your doctor about the best treatment plan for your child. Treatment options include the following:

Intravenous Gamma Globulin

Gamma globulin naturally occurs in the body. It is a protein that helps your body fight infections. This treatment provides a concentrated dose of gamma globulin. It is passed into your bloodstream through an IV.
This treatment may decrease the risk of heart complications. It is most effective when given early in the illness, ideally the first 10 days.

Aspirin

High doses of aspirin may also be recommended. Aspirin may help to manage symptoms by:
  • Preventing the formation of blood clots
  • Reducing fever
  • Easing joint swelling
  • Treating rashes
Note : If your child is given aspirin therapy and develops symptoms of a viral infection, especially chickenpox , call the doctor about stopping aspirin therapy. Aspirin has been associated with Reye’s syndrome , a potentially fatal condition.

Other Medications

Steroid or joint inflammation medication may also be recommended. They may be used if inflammation can not be controlled with treatments above.
If heart complications develop, they will need to be treated. Specific treatment will depend on the specific problem.
If heart complications develop, they will need to be treated. Specific treatment will depend on the specific problem.

Prevention

There is no known way to prevent Kawasaki disease.

RESOURCES

American Heart Association http://www.americanheart.org/

Kawasaki Disease Foundation http://www.kdfoundation.org/

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/

References

Kawasaki Disease. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/CardiovascularConditionsofChildhood/Kawasaki-Disease%5FUCM%5F308777%5FArticle.jsp . Accessed on December 10, 2012.

Kawasaki diseases. American Academy of Family Physicians Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/kawasaki-disease.html . Accessed on December 10, 2012.

Kawasaki diseases. Nemours KidsHealth website. Available at: http://kidshealth.org/parent/medical/heart/kawasaki.html . Updated September 2011. Accessed on December 10, 2012.

Kawasaki diseases. Cincinnati Children's Hospital website. Available at: http://www.cincinnatichildrens.org/health/k/kawasaki/ . Updated May 2012. Accessed on December 10, 2012.

Kawasaki disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 7, 2012. Accessed December 10, 2012.

Newburger JW, Takahashi M, Gerber MA, et al. AHA scientific statement: diagnosis, treatment, and long-term management of Kawasaki Disease. Circulation . 2004;110:2747-2771.

Taubert KA, Shulman ST. Cardiovascular medicine: Kawasaki disease. Am Fam Physician . 1999;59(11).

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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