Kawasaki disease (कावासाकी रोग in Hindi) is a rare condition that mostly affects children. This condition leads to the inflammation or swelling of blood vessels throughout your child’s body. 

If left untreated, it can cause damage to the blood vessel walls, especially of those which supply the heart (coronary arteries). Kawasaki disease is one of the leading causes of acquired heart disease in children and young infants.

This condition mostly affects children under the age of 5 and infants who are above 6 months. It is less common in older children and in adolescents. It is not a contagious disease, nor does it run in families. This disease is more common in boys and in Asians and Asian-Americans. 

Though this condition can lead to serious complications, most cases show mild symptoms and recover without any serious problems. 

Identifying the symptoms and providing treatment at an early stage helps in minimizing the risk of complications. 

Read on to understand the causes and symptoms of Kawasaki disease in children.

Causes of Kawasaki Disease

The exact cause of Kawasaki disease is not known. A number of studies link the disease to bacteria, viruses, or some environmental factors. 

Research also suggests that some genes (the basic unit of heredity) and a defective immune system may also play a role in the development of the condition. However, there is not enough evidence to back up these findings. 

Some factors that increase the risk of developing the disease include the following:

  • Age: Children who are below the age of 5 are mostly affected.

  • Gender: The condition is slightly more common in boys than girls.

  • Ethnicity: It is more common in children who are of an Asian descent.

Symptoms of Kawasaki Disease

The symptoms of Kawasaki disease appear in three phases:

First Phase

  • High fever (above 101 °F) that lasts for more than 3 days. The fever usually does not come down with medications.

  • Red, bloodshot eyes without any drainage or crusting.

  • Rash, that can appear anywhere on the body but is more commonly seen in the genital area.

  • Swollen bright red tongue, which is referred to as a “strawberry tongue”.

  • Swollen lymph nodes, especially in the neck region.

  • Swollen red skin on the palms and soles of the feet.

  • Irritation in the throat, mouth, and lips.

  • Dry, red, and cracked lips.

Second Phase

  • Peeling skin on the hand and feet.

  • Stomach pain, vomiting, and diarrhoea.

  • Generalized pain in the joints.

Third Phase

During the third phase, the symptoms usually fade away unless complications develop. It can take up to 8 weeks for your child to gain back his/her normal energy levels.

You should consult your doctor if your child has a fever for three or more days. Also, notice if the fever is accompanied by any of the above symptoms. 

If yes, it is important that you seek treatment immediately, as treating Kawasaki disease within the first 10 days greatly reduces the chances of complications.

Diagnosis of Kawasaki Disease

There is no specific test to diagnose Kawasaki disease. Your doctor will discuss the symptoms and perform a physical examination. 

If Kawasaki disease is suspected, he/she will order further tests that will include the following:

  • Blood tests. Blood tests will help rule out other diseases that show similar symptoms. An increase in the white blood cell (WBC) count and anaemia [a condition where the red blood cell (RBC) count is lower than normal] would indicate Kawasaki disease.

  • Echocardiogram. It is an ultrasound (a method that uses high-frequency sound waves to view the internal organs) of the heart, that helps in determining heart function.It helps identify any abnormalities with the heart valves and the blood vessels that supply the heart.

  • Electrocardiogram (ECG). This method helps in recording the electrical activity of the heart. Here electrodes are placed over the skin, which is connected to an ECG machine with the help of lead wires. It records the heart rhythm and identifies any abnormalities with the heart function.

  • Imaging tests. Imaging tests such as X-rays or a coronary angiogram help identify any defects in the arteries or valves of the heart. A coronary angiogram is a procedure that uses X-rays to view the blood vessels (coronary arteries) that supply the heart.

Once Kawasaki disease is diagnosed, your child’s doctor would suggest starting the treatment immediately, as early intervention will help avoid complications such as damage to the blood vessels and heart problems. 

Treatment of Kawasaki Disease

Most children recover fully without any damage to their blood vessels if treatment is started early. The treatment methods include the following:

  • Gamma globulin. An intravenous infusion of gamma globulin (a class of serum protein) can help manage the symptoms of the disease and reduce the risk of damage to the blood vessels. It contains antibodies that help fight the infection.

  • Aspirin. It helps in reducing fever, and signs of inflammation in the body. Aspirin is usually not prescribed for children as it has been linked to a serious liver condition called Reye syndrome (a rare condition that causes liver damage).Kawasaki disease is an exception where aspirin is prescribed to children and therefore, it should only be given under the supervision of a doctor.

Even after recovery, it is important to closely monitor children who had Kawasaki disease. 

The doctor may recommend follow-up tests to check your child's heart health at regular intervals, often at six to eight weeks after the illness is diagnosed, and then again after six months. 

If your child was given gamma globulin, it is recommended that you wait at least 11 months before getting a live vaccine (vaccines prepared from living microorganisms). This includes the measles and chickenpox vaccines.

With proper treatment and aftercare, most children recover completely from Kawasaki disease, though it might take them a while to get back to normal.


References:

1. Kidshealth.org. 2021. Kawasaki Disease (for Parents) - Nemours KidsHealth. [online] Available at: <https://kidshealth.org/en/parents/kawasaki.html> [Accessed 20 July 2021].

2. HealthyChildren.org. 2021. Kawasaki Disease in Infants & Young Children. [online] Available at: <https://www.healthychildren.org/English/health-issues/conditions/heart/Pages/Kawasaki-Disease.aspx> [Accessed 20 July 2021].


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