Kawasaki Disease: Causes , Symptoms & Treatment

Kawasaki Disease, though rare, is a perplexing paediatric illness characterized by inflammation of blood vessels throughout the body. Its  cause precise remains elusive, making early diagnosis crucial. Symptoms often mimic other common childhood illnesses, posing diagnostic challenges.

Without prompt treatment, Kawasaki Disease can lead to severe complications, including damage to the heart. Understanding its symptoms, diagnosis, and treatment is essential for timely intervention and improved outcomes.

What is Kawasaki Disease?

Kawasaki disease, also known as Kawasaki syndrome, is a rare form of vasculitis characterized by inflammation of blood vessels. Inflammation can cause blood vessels to weaken and expand, increasing the risk of tearing or narrowing. This restricts blood flow, limiting the nourishment of tissues and organs.

Kawasaki disease primarily occurs in children aged 6 months to 5 years. While it affects all arteries, the greatest concern is for the coronary arteries, which supply blood to the heart. Children with affected coronary arteries may experience heart complications.

With timely treatment, most children typically recover within approximately two months.

What are the Symptoms of Kawasaki Disease?

Kawasaki disease (KD) is characterized by distinct stages and seasonal patterns, typically emerging in late winter and spring, peaking in some Asian regions during summer. 

Early Stages (Symptoms lasting up to two weeks)

• Prolonged high fever (≥ 5 days)
• Rash on torso and groin
• Bloodshot eyes (non-crusting)
• Swollen, bright red lips
• “Strawberry” tongue with shiny, red spots
• Swollen lymph nodes, hands, feet
• Red palms and soles
• Heart complications may manifest.

Late Stages (Within two weeks of fever)

• Peeling skin on hands, feet
• Possible temporary arthritis

Other Symptoms

• Abdominal pain, vomiting, diarrhoea
• Enlarged gallbladder, temporary hearing loss

Contact your doctor if your child shows these signs, especially if under 1 or over 5 years old. Such children, comprising 25% of KD cases, face an increased risk of heart complications.

What are the Causes of Kawasaki Disease?

The exact reason behind Kawasaki disease remains a mystery, although it tends to occur more frequently during late winter and early spring. Scientists are investigating potential causes such as infections, environmental elements, or genetic factors.

What are the Complications of Kawasaki Disease?

Complications associated with Kawasaki disease include:

• Development of aneurysms (weakening or stretching) in the inflamed coronary arteries, potentially necessitating coronary artery bypass surgery in severe cases.
• Formation of blood clots and narrowing within the coronary arteries.
• Risk of coronary artery rupture.
• Dysfunction of heart valves that regulate proper blood flow.
• Inflammation of the heart (myocarditis).
• Hepatitis affects the child’s liver.
• Pulmonary inflammation affects the child’s lungs.
• Heart infections.
• Pancreatitis (pancreas inflammation).
• Impaired heart function or heart failure.
• Potential occurrence of a heart attack.

How is Kawasaki Disease Diagnosed?

Kawasaki disease is diagnosed based on symptoms and by ruling out similar illnesses, including:

• Scarlet fever
• Juvenile rheumatoid arthritis
• Measles
• Toxic shock syndrome
• Idiopathic juvenile arthritis
• Juvenile mercury poisoning
• Medical reactions
• Rocky Mountain spotted fever

Paediatricians might conduct these tests to assess the impact on the heart:

• Echocardiography: to monitor heart health over time
• Blood tests: looking for elevated white blood cells and inflammation
• Chest X-ray: to check for heart failure or inflammation
• Electrocardiogram: to detect heart irregularities

Kawasaki disease should be suspected in any child with a fever lasting over five days, especially if accompanied by symptoms like peeling skin.

Also Read: Cardiac Arrest vs. Heart Attack: Know the Key Differences & Signs

What is the Treatment for Kawasaki Disease?

Treatment for Kawasaki disease typically involves several approaches to address its symptoms and prevent complications. Here’s what’s typically involved:

• Immune Globulin (IVIG): Administered intravenously, but about 10% of children might require a second dose or alternative medications if they don’t respond to the initial treatment.
• Aspirin: Used to reduce pain and inflammation, although dosage and duration depend on the child’s condition.
• IV Fluids: Given for hydration and to maintain electrolyte balance.
• Medications: Prescribed for pain relief and to reduce swelling.
• Anticoagulants: Administered to individuals at risk of developing blood clots.
• Steroids or Anti-Inflammatory Drugs: Used in severe cases to reduce inflammation.

During treatment, your child will stay in the hospital to achieve the following treatment goals:

• Reduce inflammation
• Prevent arterial damage
• Minimize blood clot risks
• Prevent heart-related complications

Cold compresses may also be applied to alleviate discomfort and reduce fever during treatment.

Conclusion

Kawasaki disease is a complex condition that requires prompt recognition and treatment. With ongoing research and awareness, we can improve outcomes for affected children and advance our understanding of this enigmatic disease. Early diagnosis remains pivotal in preventing complications and ensuring better long-term health for patients. It is always advisable to seek medical help from a paediatrician. Timely care and help can ensure an appropriate diagnosis and treatment of your condition. 

At the CK Birla Hospital, we ensure patients get holistic medical support which includes treatment in a compassionate environment. This patient-centric approach not only helps patients heal better but also ensures they are aware of the preventive measures as well. In case you need to consult a paediatrician, reach out to us, or book a direct appointment with paediatrician at the CK Birla Hospital. 

FAQs

Can Adults Develop Kawasaki Disease?

Although rare, adults can develop Kawasaki disease. It typically affects children, but adult cases can occur, often with different symptoms and outcomes compared to paediatric cases.

Is Kawasaki Disease Contagious?

Kawasaki disease is not contagious; it is believed to be triggered by an abnormal immune response to certain infections, but it does not spread directly from person to person.

How is Kawasaki Disease Different from other Childhood Illnesses?

Kawasaki disease is distinct due to its inflammatory nature affecting blood vessels, causing fever, rash, and swollen lymph nodes. It can lead to coronary artery complications if untreated, unlike typical childhood illnesses.

Are there any Long-Term Effects of Kawasaki Disease?

Yes, Kawasaki disease can lead to long-term effects, primarily affecting the heart. Complications may include coronary artery abnormalities, aneurysms, and risk of cardiovascular problems, requiring ongoing monitoring and care.

What are the Risk factors for Developing Coronary Artery Abnormalities in Kawasaki Disease?

Risk factors for developing coronary artery abnormalities in Kawasaki disease include delayed treatment, younger age, male gender, prolonged fever duration, and certain laboratory findings like elevated inflammatory markers and low albumin levels.

Can Kawasaki Disease be Prevented?

Currently, Kawasaki disease cannot be prevented as its exact cause is unknown. Early diagnosis and prompt treatment with intravenous immunoglobulin (IVIG) can help reduce complications and improve outcomes.