Symptoms of Kawasaki disease

Symptoms of Kawasaki disease:

Kawasaki disease (KD), also known as Kawasaki syndrome or mucocutaneous lymph node syndrome, is a rare but serious inflammatory condition that primarily affects children under the age of 5. It causes inflammation in the walls of blood vessels throughout the body, including the coronary arteries, which supply blood to the heart. If left untreated, it can lead to severe complications, such as coronary artery aneurysms. Here’s a comprehensive overview of Kawasaki disease:

Causes

The exact cause of Kawasaki disease is unknown, but it is believed to involve a combination of genetic, environmental, and infectious factors. Possible triggers include:

Infections: Viral or bacterial infections may trigger an abnormal immune response.
Genetic Predisposition: Certain genes may increase susceptibility.
Autoimmune Response: The immune system may mistakenly attack the body’s own tissues.

Symptoms

Kawasaki disease occurs in phases, with symptoms evolving over time:

Acute Phase (Weeks 1-2):

High fever (above 102°F or 39°C) lasting at least 5 days.
Rash (often on the torso, groin, or limbs).
Red, bloodshot eyes (conjunctivitis) without discharge.
Swollen, red lips and tongue (“strawberry tongue”).
Swollen, red palms and soles of feet.
Swollen lymph nodes in the neck (cervical lymphadenopathy).
Irritability and fussiness.

Subacute Phase (Weeks 2-4):

Peeling skin on fingers and toes.
Joint pain and swelling.
Abdominal pain, diarrhea, or vomiting.
Continued irritability.

Convalescent Phase (Weeks 4-6):

Symptoms gradually resolve.
Fatigue and weakness may persist.

Diagnosis

There is no specific test for Kawasaki disease. Diagnosis is based on clinical criteria and ruling out other conditions with similar symptoms (e.g., scarlet fever, measles, or juvenile rheumatoid arthritis). Diagnostic criteria include:

Fever lasting at least 5 days.
Presence of at least 4 of the following:
1. Rash.
2. Swollen lymph nodes.
3. Red eyes.
4. Changes in lips, mouth, or tongue.
5. Swelling or redness of hands and feet.

Additional tests may include:

Blood tests (elevated white blood cell count, C-reactive protein, and erythrocyte sedimentation rate).
Echocardiogram (to check for coronary artery abnormalities).
Urine tests (to rule out other conditions).

Complications

If untreated, Kawasaki disease can lead to serious complications, particularly involving the heart:

Coronary Artery Aneurysms: Weakening and bulging of coronary artery walls.
Myocarditis: Inflammation of the heart muscle.
Pericarditis: Inflammation of the lining around the heart.
Arrhythmias: Irregular heartbeats.
Heart Failure: In severe cases.

Treatment

Early treatment is critical to reduce the risk of complications. The standard treatment includes:

Intravenous Immunoglobulin (IVIG):
- A single high dose is given to reduce inflammation and prevent coronary artery damage.
- Most effective when administered within the first 10 days of illness.
Aspirin:
- High doses are given initially to reduce inflammation and fever.
- Lower doses are continued for several weeks to prevent blood clots.
Corticosteroids or Other Immunosuppressants:
- Used in cases where IVIG is ineffective or contraindicated.
Supportive Care:
- Fluids, rest, and monitoring for complications.

Prognosis

With timely treatment, most children recover fully without long-term complications.
About 25% of untreated children develop coronary artery abnormalities.
Regular follow-up with a cardiologist is essential for children with heart involvement.

Prevention

Since the cause of Kawasaki disease is unknown, there are no specific prevention measures. However, early recognition and treatment are key to preventing complications.

When to Seek Medical Help

Contact a healthcare provider if your child has:

A persistent high fever (lasting more than 4-5 days).
Symptoms such as rash, red eyes, swollen hands/feet, or irritability.
Signs of dehydration or severe discomfort.

Kawasaki disease is a medical emergency that requires prompt diagnosis and treatment. If you suspect your child has Kawasaki disease, seek immediate medical attention to reduce the risk of long-term complications.