Kawasaki disease is the most common form of “vasculitis” that primarily affects children. Vasculitis (plural: vasculitides), is a group of diseases featuring inflammation of the wall of blood vessels including veins (phlebitis) arteries (arteritis) and capillaries due to leukocyte migration and resultant damage. Kawasaki disease produces irritation and inflammation of many tissues of the body, including the hands, feet, whites of the eyes, mouth, lips, and throat. Characteristics of this illness are high fever and swelling of the lymph nodes in the neck.
Kawasaki disease occurs more often in Japan than in any other country. In the US , children of Asian or Asian American heritage are affected more often than other races, although Kawasaki disease can occur in any racial or ethnic group. The average age child seen with the illness is 2 years old and it occurs in boys twice as often as in girls. According to the American Heart Association, the illness is a major cause of heart disease in children. In most cases, the effects on the heart caused by Kawasaki disease are temporary, and resolve within five or six weeks.
About 4,000 children are diagnosed in the US each year. Kawasaki disease, together with acute rheumatic fever, is the leading cause of acquired heart disease in children in the US and Japan . It is not clear what causes Kawasaki disease. Scientists believe a virus may be responsible, but current research is still underway. Kawasaki disease does not appear to be contagious nor hereditary. It is rare for more than one child in a family to develop the disease. As a result, less than 2 percent of persons with Kawasaki disease develop the disease more than once.
The most common symptoms of Kawasaki disease are listed below. Each child may experience symptoms differently. moderate to high fever (101° F to 104° F) that rises and falls for up to three weeks irritability swollen lymph glands in the neck spotty, bright red rash on the back, chest, abdomen, and/or groin bloodshot eyes sensitivity to light swollen, coated tongue dry, red, cracked lips dark red interior surfaces of the mouth red, swollen palms of hands and soles of feet peeling skin around the nail beds, hands, or feet
swollen, painful joints In order for a child to be properly diagnosed with Kawasaki ‘s disease the child’s physician history and a physical examination will be needed. Several of the above mentioned symptoms need to be present for the child’s physician to consider Kawasaki ‘s disease as the cause for the illness. Diagnostic tests may also include: electrocardiogram (ECG or EKG) – a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
echocardiogram (echo) – a procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves. x-ray – a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. complete blood count (CBC) – a measurement of size, number, and maturity of different blood cells in a specific volume of blood.
The physician will look for an elevation in the numbers of white blood cells which normally multiply in the presence of infection and may notice elevated platelet levels with Kawasaki disease as well. erythrocyte sedimentation rate (ESR or sed rate) – a measurement of how quickly red blood cells fall to the bottom of a test tube. When swelling and inflammation are present, the blood’s proteins clump together and become heavier than normal. Thus, when measured, they fall and settle faster at the bottom of the test tube.
Generally, the faster the blood cells fall, the more severe the inflammation. urinalysis – testing of a urine sample for protein, red blood cells, white blood cells, or casts to indicate kidney disease associated with several rheumatic diseases. Specific treatment for Kawasaki disease will be determined by your child’s physician based on: your child’s age, overall health, and medical history extent of the disease your child’s tolerance for specific medications, procedures, or therapies expectations for the course of the disease your opinion or preference.
Once the diagnosis of Kawasaki disease is made, the child’s physician may prescribe aspirin to help decrease the inflammation that the illness produces, as well as to prevent clots from forming. Some children benefit from an intravenous (IV) medication called gamma globulin that may decrease the risk of the heart being affected. Your child may need to stay in the hospital for a few days if IV gamma globulin is prescribed. Currently, there is no known way to prevent Kawasaki disease. About 80 percent of all children have a full recovery after Kawasaki disease resolves.
If an aneurysm is detected, echocardiograms will be repeated periodically, sometimes for several years after the illness. Some heart problems may not be evident right away, so it is important to keep follow-up appointments with your child’s physician, even if your child is feeling well. There is a risk for early coronary artery disease after having Kawasaki disease.
Preventive measures such as heart-healthy living habits and regular follow-up with a cardiologist should be continued throughout the lifespan. Sources: http://www. lpch. org/DiseaseHealthInfo/HealthLibrary/cardiac/kawasaki. html http://en. wikipedia. org/wiki/Vasculitis.