Kawasaki disease is a rare childhood condition that involves inflammation of the blood vessels, especially the coronary arteries. It is a disease of infants and young children, usually aged 2 years and younger, with boys afflicted more often than girls. Although all racial groups are affected, children of Asian ancestry are more likely to develop the disease.
Kawasaki is an acute disease involving high fever, rashes and joint pain and swelling. It requires hospitalization. The blood vessel inflammation can result in long-term heart complications if not treated properly.
Kawasaki disease is not well understood. The cause is unknown. It is thought to be an autoimmune disease, which means the body’s immune system mistakenly attacks its own tissues. Scientists suspect an infection may play a role in the triggering the autoimmune response.
Kawasaki disease often begins with a fever of 102 °F or as high as 104 °F. The fever will commonly last 5 days or may last for up to 2 weeks.
Other symptoms often include:
- Bright red, chapped or cracked lips
- Cough and runny nose
- Diarrhea, vomiting and abdominal pain
- Joint pain and swelling, often on both sides of the body
- Peeling skin in the genital area, hands and feet (mostly around the nails, palms and soles)
- Red mucous membranes in the mouth
- Red palms of the hands and the soles of the feet
- Skin rashes (not blisters) on the middle of the body
- Strawberry tongue, white coating on the tongue, or visible red bumps on the back of the tongue
- Swollen hands and feet
- Swollen lymph nodes in the neck (often only one lymph node is swollen)
- Very bloodshot or red eyes (without pus or drainage)
Most of the time, the doctor will diagnose the disease based on signs and symptoms. Tests alone cannot diagnose Kawasaki disease. Tests such as electrocardiography and echocardiography are done to look for signs of heart damage, including myocarditis, pericarditis and inflammation of the coronary arteries.
Children with Kawasaki disease need hospital treatment. Treatment must be started right away to prevent damage to the coronary arteries and heart, and to prevent aneurysm formation. Most children can recover fully when the disease is caught and treated early.
High-dose intravenous gamma globulin is the standard treatment. It is a biological product that comes from donor blood and contains antibodies. The child's condition often gets much better within 24 hours of this treatment. High-dose aspirin is often given along with it.
Although most children recover fully, up to 1 in 4 children may still develop problems in their coronary arteries, even with proper treatment. About 1 in 100 patients die from heart problems caused by the disease. People who have had Kawasaki disease should have an echocardiogram every one to two years to screen for heart problems. Other self-management would depend upon the condition of the heart and the heart vessels, and will be determined by the heart doctor.