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Kawasaki Disease: Symptoms, Diagnosis and Treatments

Kawasaki-symptoms diagnosis and treatments
Dr. Monika Bhanushali
Dr. Monika Bhanushali
August04/ 2016


Kawasaki disease is disease affecting the medium sized blood vessels of the body. The disease was first explained by Tomisaku Kawasaki from Japan in 1967, hence the disease is named after him.

This disease mainly affects the children younger than 5 years of age. It not only affects the blood vessels but also skin, lymph nodes and mucous membranes. It can also affect the heart which can result in life threatening sequelae.

If not identified on time, it has a mortality rate of 1% within the 6 weeks of its contraction. The definite cause of the disease is yet unknown. It is most commonly seen in patients with having viral infection from before.The affection by this disease is mostly common in winter and early summer.

Kawasaki disease is also a type of auto immune disease where the body fails to recognise its cells as its own and attack them as it would a foreign body or pathogen.

The disease presents with a peculiar group of symptoms. They are as follows:

  1. Fever lasting for 5 days
  2. Redness of the eyes
  3. Rash on the body
  4. Swollen and cracked lips and tongue, this tongue presentation is popularly known as “strawberry tongue”.
  5. Irritability, Consistent crying
  6. Swollen and red hands and feet
  7. Swelling of the lymph node in the neck
  8. Joint pain, pain in chest, abdomen, diarrhoea, jaundice can also be present sometimes.

Investigations:

  1. Blood test: the child may have anaemia and increased white blood cells
  2. Raised Erythrocyte sedimentation rate
  3. Liver function may show mild derangement
  4. ECG: may show arrhythmia due to involvement of the heart tissue
  5. Echo: echocardiogram may show aneurysms in the arteries supplying blood to the heart muscle.
  6. Urine examination: It may reveal blood cells or proteins in the urine.
  7. Lumbar puncture: it is done to obtain the cerebrospinal fluid may show meningitis

Treatment:

The child suffering from Kawasaki disease should be treated by experienced doctor who has handled Kawasaki cases before. Treatment should be started as soon as possible after the diagnosis is confirmed. It is pertinent in delaying or avoiding lasting damage to the heart and the coronary arteries.

1.Intravenous immunoglobulin:

It is the first line of treatment for Kawasaki disease. It is administered in high doses. It generally shows tremendous improvement within 24 hours.

2.Aspirin:

It is an important part of the treatment for the Kawasaki disease. It is started at high doses and as the fever subsides, it is continued even after the patient returns home for at least 2 months.

3.Corticosteroids:

They are also quite useful in reducing the inflammation of the arteries and improving the outcome.

  1. Plasma exchange, infliximab, IL-1 and cyclophosphamide are some of the new treatments modalities with varying degrees of success.

Outcome:

As early the treatment commences, better is the outcome. The acute symptoms are corrected rapidly. The risk of coronary artery aneurysm is reduced.

Complications:

If remained undiagnosed for a longer duration, it may result in following complications:

  1. Coronary artery aneurysm
  2. Meningoencephalitis
  3. Cerebral ischemia or infarct
  4. Subdural effusion
  5. Aortic aneurysm
  6. Intestinal obstruction
  7. Ocular artery obstruction

Is your child suffering from fever for more than 5 days with the given presentation of symptoms? Contact your nearest physician in the earliest.

Dr. Monika Bhanushali
Dr. Monika Bhanushali

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