Health News and Information – Bolton (MA) Family Practice Physicians

Kawasaki disease is an autoimmune disorder that causes the medium sized blood vessels in the body to become inflamed.  It is generally seen in children under the age of five.  It affects many organ systems including the blood vessels, skin, mucus membranes, and lymph nodes.  Its most serious effect is on the heart where it can cause a fatal condition in untreated children.  Without treatment, the mortality rate is about one percent in the United States.  With treatment the mortality rate is.001 percent.  Kawasaki disease is most prevalent in Japan, where it was first discovered in 1967.  It remains a very poorly understood disease whose cause remains undetermined.  Kawasaki disease is an interesting disease that was discovered relatively recently and is still being vigorously researched by scientists around the world.

Symptoms of Kawasaki Disease

The initial symptom of Kawasaki disease is often a high, persistent, fever greater than 102 and sometimes as high as 104 degrees Fahrenheit.  The fever often lasts as long as five days and is generally not affected by the use of over the counter fever reducing drugs like Tylenol or Motrin.  Other symptoms include: extremely red, bloodshot, eyes with no pus or drainage; bright red, chapped and cracked lips; red mucous membranes in the mouth; a “strawberry” tongue covered with white coating and red bumps; red palms on the hands and feet; swollen hands and feet; skin rashes on the hands and feet; peeling skin; swollen lymph nodes; and joint pain and swelling.

Diagnosis

There is no test to specifically diagnose Kawasaki disease.  The diagnosis is usually made based in the patient’s classic symptoms.  Any child with a high fever lasting longer than five days should be checked for Kawasaki disease.  In fact, some doctors are now advising that children who present with a fever lasting three days long and who show several of the other symptoms should see a doctor as well.  Doctors usually perform a battery of tests on their patients to aid them in their diagnosis.  This battery of tests includes, but is not limited to, a chest x-ray, complete blood count, c-reactive protein test, echo-cardiogram, electrocardiogram, ESR, serum albumin, serum transaminase, and urinalysis.

Treatment and Prognosis

Children diagnosed with Kawasaki disease are admitted to the hospital for treatment.  It is imperative that treatment begin as soon as the patient is diagnosed in order to prevent damage to the coronary artery and the heart.  The standard treatment is intravenous gamma globulin given in high doses.  The child’s condition usually greatly improves after the first treatment.  With early diagnosis and prompt treatment a full recovery can be expected.  It is rare for symptoms to reoccur after a patient has been treated.  Patients who have been treated for Kawasaki disease should receive an echo-cardiogram every one to two years to screen for heart disease.

Cause

The cause of Kawasaki disease is still unknown.  However, like most autoimmune diseases it is presumably caused by an interaction of genetic and environmental factors, possibly including an infection.  There is some evidence that the cause could be a wind born pathogen but no conclusive evidence has yet been found.

Kawasaki disease is a relatively new disease whose cause and origin are still managing to elude scientists and doctors.  This is a serious disease that requires immediate diagnosis and treatment.  It is not likely to be fatal, with only one percent of untreated children die as a result, but it can cause serious problems in other organ systems in the body.  If you are worried your child is suffering from Kawasaki disease take them to your physician as soon as possible.  The early treatment is started the better chance your child has of making a full recovery.  Kawasaki disease is an interesting case in that it was so recently discovered and is so little understood.  There are not many diseases whose cause is still unknown.  There are many scientists around the world working tirelessly to discover the cause of this disease so that we can hopefully begin working on a preventive  cure.