Kawasaki Disease: Symptoms, Causes, Treatment

What are the symptoms of Kawasaki disease?

Kawasaki disease is a rare childhood illness that primarily affects children under the age of 5. The symptoms typically include:

1. High Fever: Persistent high fever (often over 102.2°F or 39°C) lasting for at least five days.
2. Rash: A rash, often peeling on the hands and feet, sometimes starting in the groin area.
3. Red Eyes: Conjunctivitis (red eyes without discharge).
4. Swollen Lymph Nodes: Swollen lymph nodes, usually in the neck area.
5. Changes in Mouth and Lips: Red, cracked lips; a “strawberry” tongue (red and bumpy); and mucous membrane changes in the mouth.
6. Swelling and Redness of Hands and Feet: Swelling and redness of the hands and feet, often followed by peeling of the skin.
7. Irritability: Children may be irritable or fussy due to the fever and other symptoms.
8. Joint Pain: Joint pain and swelling, particularly in the larger joints like the knees.

It’s important to note that not all symptoms may be present, and they can vary in intensity from child to child. If Kawasaki disease is suspected, prompt medical attention is crucial to prevent complications.

What are the causes of Kawasaki disease?

The exact cause of Kawasaki disease is not fully understood. It is believed to be a combination of genetic, environmental, and possibly infectious factors, but no single cause has been identified definitively. Some factors that are thought to play a role include:

1. Genetics: There may be a genetic predisposition, as Kawasaki disease tends to occur more frequently in people of Asian descent and in those with a family history of the disease.
2. Infectious Triggers: Some researchers believe that Kawasaki disease may be triggered by an infectious agent, such as a virus or bacteria. However, no specific pathogen has been consistently identified as the cause.
3. Immune System Response: Kawasaki disease is considered an autoimmune-like response, where the body’s immune system mistakenly attacks its own tissues, leading to inflammation and the characteristic symptoms.
4. Environmental Factors: There may be environmental triggers that increase the risk of developing Kawasaki disease, but these factors have not been clearly identified.

Research into the causes of Kawasaki disease is ongoing, and further studies are needed to better understand the complex mechanisms involved in its development.

How is the diagnosis of Kawasaki disease made?

Kawasaki disease is a challenging diagnosis to make, as the symptoms can be nonspecific and similar to those of other conditions. However, a diagnosis of Kawasaki disease is typically made based on a combination of clinical findings, laboratory tests, and imaging studies. Here are the typical steps involved in diagnosing Kawasaki disease:

1. Medical history and physical examination: The doctor will take a detailed medical history of the child’s symptoms, including the duration and severity of fever, rash, and other symptoms. A thorough physical examination will be performed to look for signs of inflammation in the eyes, skin, and mucous membranes.
2. Clinical criteria: Kawasaki disease is diagnosed based on a set of clinical criteria established by the American Heart Association (AHA). These criteria include:
   • Fever lasting more than 5 days
   • Bilateral non-exudative conjunctivitis (inflammation of the eyes)
   • Changes in the mouth and lips (strawberry tongue and redness or cracking of the lips)
   • Rash (typically a maculopapular rash on the trunk, arms, and legs)
   • Swelling of the hands and feet
   • Enlarged lymph nodes in the neck
3. Laboratory tests: Blood tests are performed to rule out other conditions that may have similar symptoms. These tests may include:
   • Complete Blood Count (CBC) to evaluate for signs of inflammation
   • Erythrocyte sedimentation rate (ESR) to assess for inflammation
   • C-reactive protein (CRP) to measure inflammation
   • Blood cultures to rule out bacterial infections
4. Echocardiogram: An echocardiogram (ultrasound of the heart) is used to evaluate for signs of coronary artery aneurysms or inflammation of the coronary arteries.
5. Imaging studies: In some cases, additional imaging studies such as MRI or CT scans may be ordered to rule out other conditions that may have similar symptoms.

If a child meets the clinical criteria and laboratory tests support the diagnosis, a diagnosis of Kawasaki disease is made. In some cases, a biopsy of skin lesions or other tissues may be performed to confirm the diagnosis.

It’s essential to note that Kawasaki disease can only be diagnosed by an experienced pediatrician or cardiologist who has experience with this condition. A prompt diagnosis and treatment are crucial to prevent long-term complications, such as coronary artery aneurysms and cardiac damage.

What is the treatment for Kawasaki disease?

The treatment for Kawasaki disease typically involves:

1. Intravenous Immunoglobulin (IVIG): This is the primary treatment to reduce inflammation in the blood vessels and prevent coronary artery abnormalities. It’s usually given as a single dose along with aspirin.
2. Aspirin: Given in high doses initially to reduce inflammation and prevent blood clots, then in lower doses to prevent clotting in the coronary arteries.
3. Supportive Care: This includes managing fever and other symptoms, ensuring adequate hydration, and monitoring for any complications, especially related to the heart.
4. Monitoring: Regular monitoring of heart function and coronary arteries through echocardiograms to detect any signs of coronary artery abnormalities early.

In some cases, additional treatments or therapies may be needed based on the individual’s response to IVIG and aspirin. Early treatment is crucial to prevent serious complications, particularly coronary artery aneurysms.