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Kawasaki Disease: A Heart Disorder Affecting Children

HIGHLIGHTS:

  • Kawasaki disease tends to affect young children. If not treated quickly enough, the condition can result in coronary artery disease with potentially life-threatening consequences.
  • Kawasaki disease is most common among Asian children under the age of five.
  • Prevention of Kawasaki disease is currently unavoidable, however the treatment can be successful if carried out within 10 days of the symptoms first being displayed, as this reduces the risk of complications that could arise in the coronary artery.

 

Kawasaki disease is named after a Japanese doctor, Dr. Tomisaku Kawasaki, who, in 1967, first discovered the condition in children under age 5. These children usually experience a high fever, inflammation of the hands and feet, redness in the eyes, a red skin rash, a dry redness in the mouth and bumps on the tongue which resemble the skin of a strawberry. If not treated in time, the disorder can result in coronary artery disease with potentially life-threatening consequences.

Causes and risk factors

There are currently no known causes of Kawasaki disease. The disease is most common among Asian children under the age of five, especially infants from Northeast Asian countries such as Japan and Korea. There is still no evidence to confirm that the disorder is hereditary.

Diagnosing the disease

Kawasaki’s disease should be suspected if a child is suffering from a fever higher than 38°C for more than five consecutive days, in conjunction with at least four out of the five following symptoms:

  • Red rash on the trunk or around the groin area
  • Redness and swelling on the palms of the hands or feet in the first Finger and toe peeling in the second week
  • Redness and inflammation in both eyes that doesn’t include the edge of the cornea
  • Redness and dryness of the lips alongside red bumps forming on the tongue (strawberry tongue)
  • Swollen lymph nodes that can be felt on either one or both sides of the throat

Nonetheless, doctors may decide to carry out the following additional diagnostics to identify the effects of Kawasaki disease on the patient’s heart:

  • Screening for irregularities with an echocardiogram examination that can analyze the state of coronary artery disease, as well as the heart’s contraction capabilities.
  • An electrocardiogram to assess the state of a myocardial infarction.
  • A blood test to identify inflammation by analyzing the increase in white blood cell count. This test can also analyze whether or not albumin levels are low.
  • A liver function test which may find increased levels of liver enzymes.
  • A chest X-ray to identify any potential warning signs of heart failure.

Treatment

Although there is no prevention for Kawasaki disease, successful treatment is possible when carried out within 10 days of the symptoms first being displayed. Early treatment reduces complications that could arise in the coronary artery. The most widely accepted form of medication is immunoglobulin, which is intravenously administered to prevent inflammation. This drug may be administered repeatedly if symptoms do not improve within 48-72 hours. Aspirin can also be used to help relieve pain, reduce fever and prevent thrombosis.

Most infant patients who receive timely and appropriate forms of treatment from specialist medical professionals are able to make a full recovery. However, this also depends on correct post-treatment care and strict adherence to all courses of prescribed medication.


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Resources

  1. McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation 2017; 135:e927.
  2. https://www.kawasakidiseaseuk.org/parent-guide
  3. https://www.cdc.gov/kawasaki/about.html
  4. https://www.heart.org/-/media/files/health-topics/answers-by-heart/what-is-kawasaki-disease-300320.pdf?la=en

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