Kawasaki Disease

Kawasaki disease lymph nodes

Last Updated December 20th, 2021

Kawasaki Disease – Understanding this rare condition

Also known as mucocutaneous lymph node syndrome, Kawasaki Disease is an affliction causing inflammation of blood vessels throughout the body.  It affects the arteries, capillaries, veins, and lymph nodes causing the symptoms to manifest in the facial and neck region. Primarily affecting children, Kawasaki disease if left undiagnosed can lead to heart disease in young children. It is a comparatively rare disease which affects around 8 to 67 out of every 100,000 children under the age of 5. In Japan, this number is slightly higher, with around 124 out of every 100,000 are afflicted by this condition. Boys are most susceptible to this disease than girls.

Though it is more commonly prevalent in children of Asian and Pacific Island descent, children and teenagers from all ethnicities and races can be affected by it. This condition is named after Tomisaku Kawasaki, a Japanese pediatrician who first recognized this condition as a serious ailment in 1967.

 

What causes Kawasaki disease?

Kawasaki disease lymph nodesThe factors causing the onset of this disease still remain  unknown, though a number of risk factors have been identified. An atypical genetic predisposition and its reaction to an auto-immune mechanism are hypothesized to be the primary causes of Kawasaki disease. The specific cause remains unknown but studies indicate that this disease has immunological origins.  The various risk factors are:

  • Age – Children below the age of 5 are most at risk.
  • Sex – Boys are affected more than girls.
  • Ethnicity – Children of Asian (mostly Japanese and Korean) and Pacific Island descent.
  • Genetic – Not inherited from parents but chances increase tenfold if one sibling has acquired the disease.

 

Symptoms and signs

The common tell-tale signs manifest themselves in phases, which are highly indicative of this grave medical condition.

1st stage or Early stages symptoms (1-2 weeks)

  • Persistent high fever for more than 5 days which is unresponsive to paracetamol.
  • Inflammation of the conjunctiva causing redness of eyes and thick discharge.
  • Characteristic “strawberry” tongue where the tongue becomes excessively red and swollen.
  • Vertically cracking and bleeding lips.
  • Redness in mouth and throat mucus.
  • Swelling in lymph nodes.
  • Rashes on the body (usually in the truck) and genital areas.

 2nd stage or Late stages symptoms (more than 2 weeks)

  • Peeling of skin from the hands and feet, mostly in large sheets.
  • Abdominal pain followed by diarrhea.
  • Joint Pain and even temporary arthritis.
  • Inflammatory changes in many organs which could lead to meningitis or hepatitis.
  • Vomiting and headaches. Extreme cases may cause seizures.
  • Swollen gallbladder.
  • May even cause temporary hearing loss.

Further complications

  • Heart complications are most commonly caused in children by Kawasaki disease.
  • Coronary artery aneurysms, which increase the chances of blood clots and blocked arteries, may occur if left untreated.
  • Acute rheumatic fever.
  • Myocardial infarction, which could be fatal in nature.

 

How is this condition diagnosed?

kawasaki disease red eyesIt is difficult to diagnose this condition initially since its symptoms are similar to that of scarlet fever, toxic shock syndrome, mercury poisoning, and juvenile rheumatoid arthritis.  The criteria of characteristic 5-day fever in addition to the strawberry tongue, rashes, and bloodshot eyes must be met to establish the contraction of this illness.

You should visit the doctor if any of these symptoms develop, keeping in mind that children under 1 or above 5 exhibit partial symptoms. The pediatrician will conduct the following tests to determine the extent of cardiac and other related complications:

  • Electrocardiography or ECG tests which reveal the extent of ventricular dysfunction or arrhythmia.
  • X-rays of the cardiac cavity to determine heart failures and inflammation.
  • Urine and blood tests to indicate white blood cells and protein in urea.
  • Ultrasound or CT scan to measure any enlargement in the gallbladder.
  • Liver function tests which may show hepatic inflammation.

 

Effective treatment protocol

Kawasaki Disease skin peelingKawasaki disease manifests itself initially through seemingly mild symptoms initially which can easily accelerate cardiac complications in young children. Timely detection and treatment of this disease are critical in preventing the occurrence of heart-related issues. To prevent the onset of such crippling and fatal symptoms, the treatment should begin immediately.

  • The first round of treatment includes Intravenous immunoglobulin (IVIG) which are basically antibodies injected over 12 hours. Much relief from symptoms is seen within 1st 24 hours. If not, an additional dosage is provided. This method is highly effective in preventing severe complications such as aneurysms if administered within the first seven days of the fever.
  • Medications such as aspirins are prescribed with the dosage initially set high. Once the fever recedes, for 6 to 8 weeks, a lower dosage of aspirin is prescribed. This helps in preventing the formation of blood clots.
  • When these treatment methods fail, corticosteroids are used to counter the debilitating effects of this condition.
  • Cyclophosphamide and plasma exchange methods are also considered viable options when treating Kawasaki disease.

 

Is it preventable?

Unfortunately, there are no proven methods to prevent this disease. Though it usually occurs in children under the age of 5, it can affect anybody. Early diagnosis and treatment enable the children to recover within few weeks, without further development of any aggravated syndromes. After complete recovery, in spite of the absence of any cardiac abnormalities, the child should be regularly tested for heart problems and aneurysms once every 1-2 years. Even if coronary problems are not treated completely at the time of treatment, around 60% of such cases show dramatic improvements within the first year. A repeat occurrence of Kawasaki disease is extremely rare, with only 3% patients witnessing the re-emergence of symptoms.

 

Facts

  • Earlier, it was known as mucocutaneous lymph node syndrome.
  • There are no exact diagnostic tools for detecting Kawasaki disease.
  • 1 out of 50 children suffering from this condition may develop a heart condition.

Facts

  • It is non-contagious in nature.
  • It is most commonly found in children of Asian and Pacific ethnicities and affects children who are less than 5 years of age. Boys are more susceptible than girls.
  • In the continental USA, this disease affected around 9-19 children out of every 100,000 kids.

Facts

  • In extreme cases, fatality may occur as a result of an aneurysm, though the likelihood of this happening is very low.
  • It is not contagious in nature.
  • The fever lasts for more than 5 days and is cyclical in nature.

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Dos and Don'ts

Dos
  • Have an adequate amount of Vitamin K in the child’s diet. Feed the child Vit-K rich foods like green leafy vegetables and broccoli.
  • Keep the child properly hydrated, more so in case he/she gets diarrhea.
  • Maintain a fiber-rich diet.
Don'ts
  • Give the child aspirin dosage, since it causes the blood to thin which can lead to excessive bleeding from gums or nose.
  • Administer certain vaccinations such as those for chicken-pox and measles ,within 11 months of Kawasaki Disease treatment.
  • Delay medical help on observing the symptoms.

 

 

 

 

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How are BMI and BMR different and what do these numbers mean? BMI and BMR are two important metrics that provide a clear picture of your body's metabolism and also…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
Cottage cheese: What can you find in this healthy chunk of fresh milk cheese? Love cheese but scared of putting on extra pounds? With cottage cheese, you can get the best of…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Sciatica pain relief: Get rid of the pain with these easy daily tips Researchers have claimed that not only heat but icing the area too helps relieve sciatica pain. Find out…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
Tight phimosis ring
Phimosis Read to know everything about phimosis, types, symptoms, treatment, risks and prognosis for patients with this condition.
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…