Clinical Reference Systems: Pediatric Advisor 10.0
Kawasaki Disease
What is Kawasaki disease?
Kawasaki disease (also called mucocutaneous lymph node
syndrome) is a disease that affects small and medium-sized
arteries throughout the body. Arteries are vessels that
carry blood from the heart to the tissues of the body.
Children who get Kawasaki disease develop inflammation
(swelling) of the walls of arteries. This inflammation
causes your child to have:
- a fever for 5 or more days
- skin rash
- swollen, dry, cracked lips or red, swollen tongue
- red ("bloodshot") eyes
- swollen lymph nodes in the neck
- swelling and redness of the hands and feet, sometimes
with peeling skin of the hands and feet, especially
around the tips of the fingers and toes.
Kawasaki disease is rare. It usually affects children
between the ages of 6 months and 5 years.
What is the cause?
There are many theories about why children get Kawasaki
disease, but no one really knows the cause. Medical
researchers have considered bacteria, viruses, and
environmental chemicals or pollutants as possible causes,
but none have proven to be a common link.
How is it diagnosed?
To diagnose Kawasaki disease, the doctor first needs to
check if your child has other diseases that might cause
similar symptoms. If your child has had a fever for many
days and also has four or five of the other symptoms listed
above, then the doctor will probably diagnose your child
with Kawasaki disease. A diagnosis of "atypical Kawasaki
syndrome" may be made when fever and fewer than four of the
symptoms are present.
What are the complications of Kawasaki disease?
When untreated, Kawasaki disease can cause many serious
problems including:
- Inflammation of the heart muscle. The inflammation of
the heart can make the heart muscle pump blood poorly.
- Abnormalities of the coronary arteries. Coronary
arteries, which are blood vessels that carry blood to the
heart muscle, can form aneurysms (weak, bulging areas in
the artery). Blood can clot in an aneurysm and
eventually block blood flow. When blood flow to the heart
is blocked, the heart muscle can be damaged.
- Other problems include joint swelling (arthritis), poor
digestion, diarrhea, and inflammation of the gallbladder.
For unknown reasons, children with Kawasaki disease can
be very irritable.
What is the treatment?
All children with Kawasaki disease need to be admitted to
the hospital. If the disease is diagnosed while the child
still has a fever, the complications of Kawasaki disease can
usually be prevented. First, your child will get gamma
globulins through a vein (IV). This treatment greatly
reduces the risk of heart problems, especially coronary
artery aneurysms.
If your child develops a coronary artery aneurysm, he will
need to start some long-term treatments including taking
aspirin to prevent clotting.
Your child will need to be seen regularly by a pediatric
heart specialist (cardiologist).
Call Your Child's Physician Immediately If:
- You think your child has Kawasaki disease and he is
acting very sick.
- Your child was recently diagnosed with Kawasaki disease
(1 to 2 months) and is having chest pain.
Call Your Child's Physician during Office Hours If:
- You would like more information about Kawasaki disease.
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