Kawasaki disease is a rare disorder in children. Its incidence isn’t very high, but it’s important that doctors know of its existence to detect it if it occurs in their young patients.
The key point of the condition is the inflammation of the blood vessels. It doesn’t distinguish between veins and arteries, either one can be affected.
It’s also able to inflame lymph nodes and mucous membranes in the face, such as those in the nose and mouth. For this reason, Kawasaki disease can also be called mucocutaneous lymph node syndrome in some cases.
In general, children under 5 years old are affected. It’s more frequent among boys than girls, but the difference in prevalence is minimal. Some ethnic groups have more frequency of the disorder than other regions of the world, such as Japanese people.
The cause and origin aren’t clear. Some hypotheses mention the intervention of microorganisms as triggers for symptoms, but researchers haven’t proven this claim. Some doctors also suspect there could be a family genetic predisposition, although they haven’t figured out exactly how it works.
Symptoms of Kawasaki disease
Kawasaki disease goes through three progressive phases:
- The initial symptom is high fever, almost 40 degrees Celsius (104 Fahrenheit) and 72 hours of evolution. It’s usually accompanied by conjunctivitis without blemishes and a skin rash on the torso and genital region.
- The red-eye fever plus the dermal outbreak disorient the doctors who first take care of the patient. If the lymph nodes become inflamed, subcutaneous elevations appear as a result. This usually happens to the lymph nodes in the neck and is accompanied by an increase in the size of the hands and feet.
- In the second phase of symptoms, the skin starts flaking. Skin that has been irritated and inflamed begins to peel off in large amounts, especially on the limbs. They may experience gastroenteritis with vomiting and diarrhea, as well as joint pain. The fever usually subsides by this point.
- Finally, in the last phase, no new symptoms of Kawasaki disease appear, but those that were there slowly disappear. The recovery is long and it’s difficult for the child to recover their activity level before the condition.
How do you diagnose it?
World medical associations have developed a criteria guide for diagnosing Kawasaki disease. There should always be a fever and, in addition, four of the following symptoms:
- Swelling of hands and feet
- Strawberry tongue (swollen and bumpy) and dry lips
- Peeling of the skin on the upper or lower limbs
- Skin rash with little repetitive pattern
- Cervical lymph nodes enlarged
- Conjunctivitis with red eyes
Along with the observation of symptoms, the doctor must rule out other conditions that could be confused with Kawasaki disease. If you have reasonable suspicions, you should request an echocardiogram, which will detect inflammation of the blood vessels.
Kawasaki Disease Treatment
The treatment for patients with Kawasaki disease is based on gamma globulins, aspirin, and anticoagulants. The intention is to stop the formation of aneurysms due to inflammation of the blood vessels.
Gamma globulins are inserted intravenously and are a key tool in stopping complications arising from the disease. In fact, doctors have noted that its greatest benefit is in preventing changes in the coronary arteries.
As for aspirin, doctors use it as an anti-inflammatory. Luckily, it also reduces fever and is a pain reliever, which would help with other symptoms, such as fever and joint pain. Aspirin is known to have certain adverse effects in children, so we recommend closely monitoring patients under this treatment.
About 10% of affected children will have continuing issues after recovery, mainly in the coronary arteries. They can even appear in 10% of patients treated on time, so we recommend subsequent follow-up with complementary methods.
A rare but treatable disease
Unlike other conditions, Kawasaki disease has a treatment plan and approach. Success depends a lot on accurate and early diagnosis. In Asian countries, doctors are more alert for detection, but cases have been reported worldwide. When the conditions we described are met, you may have a case of Kawasaki disease.