Kawasaki Disease

What is Kawasaki disease?

Kawasaki disease is a rare childhood condition that mainly affects children under the age of five. It causes inflammation in the walls of the blood vessels, leading to a number of symptoms, such as rash, swelling, fever and swelling and inflammation of the mouth and tongue (which is known as “strawberry tongue” due to the red, swollen appearance).

Kawasaki disease affects 8 out of every 100,000 children in the UK and is more common in boys than girls.

Prognosis of Kawasaki disease

Most children recover within six to eight weeks if Kawasaki disease is properly diagnosed and treated. The sooner treatment begins, the faster the recovery and the less chance of complications.

Complications can occur if Kawasaki disease affects the coronary arteries (the blood vessels that supply blood to the heart). The inflammation that occurs here can cause an aneurysm, which can lead to blood clots and, in turn, heart disease or even heart attacks. Complications such as these can be fatal, but occur rarely. However, children who experience heart-related complications due to Kawasaki disease may suffer permanent heart damage or a higher risk of developing heart conditions later in life.

The first symptom of Kawasaki disease is usually a fever that does not respond to normal remedies.

Symptoms of Kawasaki disease

The first symptom of Kawasaki disease is usually a fever that does not respond to normal remedies. Other typical symptoms may include:

  • Rash
  • Dry or chapped lips
  • Swollen glands in the neck
  • Red eyes
  • Redness and/or swelling in the fingers or toes
  • Swelling inside the mouth, including “strawberry tongue” — the tongue becomes very red and swollen and may have small bumps.
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During the second phase of the disease, there may be peeling of the skin and other symptoms, such as abdominal pain, vomiting, diarrhea, fatigue, joint pain and headache.

Symptoms begin to improve and disappear in the third stage, although the child may tire easily until full recovery.

Medical tests to diagnose Kawasaki disease

Diagnosis of Kawasaki disease is usually based on the presence of at least four key symptoms (rash, swollen lymph nodes, changes (e.g., swelling) in the mouth or throat, changes in the hands or feet, and conjunctival infection in both eyes), along with a fever lasting more than five days. There is no single test to diagnose the condition, but several tests may be performed to rule out other conditions such as scarlet fever, measles, glandular fever, and lupus.

What causes Kawasaki disease?

Kawasaki disease is not preventable. It is not clear exactly what causes it, but there are several theories:

  • Infection, i.e. caused by bacteria or viruses: the symptoms are similar to those of other infections, but it is not contagious, so a viral cause alone is unlikely to act.
  • Genetic: Kawasaki disease is more common in certain populations, e.g. Japan and Korea, which may mean that certain genes are predisposed to the disease.
  • Autoimmune: the body’s immune system mistakenly attacks healthy cells.
  • Environmental: reaction to a pollutant, toxin, chemical or drug.
  • A combination of the above.

Treatments for Kawasaki disease

Kawasaki disease is usually treated in the hospital due to the age of the patients and the severity of possible complications.

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Treatment includes two key components:

  • Intravenous immune globulin: a solution of donated antibodies that is injected directly into a vein and helps the body’s immune system.
  • Aspirin: you should never give aspirin to a child unless prescribed by a doctor. Kawasaki disease is one of the special occasions when this can happen. Aspirin helps reduce inflammation, swelling, fever and pain, while also acting as an antiplatelet (helps prevent blood clots).

What type of specialist treats Kawasaki disease?

Pediatricians and pediatric cardiologists treat Kawasaki disease.