Kawasaki disease is a serious illness primarily affecting young children, often under five years old, causing inflammation of blood vessels throughout the body. Recognizing its signs and symptoms is important for timely medical attention. This article aims to increase awareness of Kawasaki disease and the benefits of early diagnosis.
What is Kawasaki Disease?
Kawasaki disease is a rare but serious condition characterized by vasculitis, or inflammation of blood vessels, throughout the body. This inflammation particularly affects medium-sized arteries, especially the coronary arteries supplying the heart. It predominantly affects infants and young children, typically aged six months to five years, though it can occur in older children.
The exact cause of Kawasaki disease is unknown, but it is not contagious. Researchers believe it may be an immune reaction to various infectious agents in genetically susceptible individuals. It is recognized as a leading cause of acquired heart disease in children in developed countries.
Recognizing the Signs
Recognizing the signs of Kawasaki disease can be challenging, as symptoms may resemble other childhood illnesses and not all appear simultaneously. A persistent high fever, lasting at least five days, is usually the first and most consistent symptom. This fever often does not respond to typical fever-reducing medications.
A rash frequently appears on the body and can vary in appearance. Children may also exhibit very red eyes, known as conjunctival injection. The lips can become red, dry, and cracked, and the inside of the mouth and throat may be inflamed. A distinctive “strawberry tongue,” which is a red, swollen tongue with small bumps, is also a common finding.
Swelling and redness of the hands and feet, often with tenderness, can occur, followed by skin peeling around the fingers and toes. Additionally, swollen lymph nodes may be present.
Why Early Diagnosis Matters
Timely diagnosis of Kawasaki disease is important due to the potential for serious complications if left untreated. Without prompt intervention, approximately 25% of affected children can develop coronary artery aneurysms, which are bulges or weak spots in the walls of the coronary arteries supplying blood to the heart.
Coronary artery aneurysms can lead to severe heart problems later in life, including blood clots that may cause a heart attack. Early treatment, ideally initiated within 10 days of fever onset, can significantly reduce the risk of these cardiac complications to less than 5%. Treatment is still recommended if there is ongoing inflammation or evidence of coronary artery involvement, even if symptoms persist beyond 10 days.
Treatment Approaches
Treatment for Kawasaki disease typically involves hospitalization, focusing on reducing inflammation and preventing heart complications. The primary treatment is intravenous immunoglobulin (IVIG), a solution of antibodies from healthy donors, administered directly into a vein. IVIG reduces inflammation and decreases the risk of coronary artery aneurysms.
Aspirin therapy is also standard. High-dose aspirin is initially given for its anti-inflammatory effects to reduce fever and discomfort. Once fever subsides, a lower dose is often continued for several weeks to prevent blood clot formation, particularly in the coronary arteries. Follow-up care, including regular echocardiograms, monitors the heart and coronary arteries for involvement.