Identifying Kawasaki Disease

Named after Dr. Tomisaku Kawasaki who recognized the syndrome in 1967, Kawasaki disease affects children, usually under age 5, by inflaming the blood vessels and exposing the coronary arteries carrying blood to the heart. It also goes by Mucocutaneous Lymph Node Syndrome due to its effects on the lymph nodes, skin, and the nose, mouth, and throat lining.

Despite being the leading cause of acquired heart disease in children, the condition rarely causes any permanent damage if treated efficiently. Take your child to a rheumatologist or a pediatrician for an accurate analysis.

Causes:

While the exact cause is unknown, Kawasaki disease is suspected to be inherited in some part owing to multiple occurrences in the same family and most of the affected children being of east Asian descent (e.g. Japan and Korea). However, the condition can affect children from any ethnic group. Similarly, certain viruses and bacteria may also cause the disease as it is more prevalent during winter and spring. But again, the condition can also occur year-round.

Symptoms:

The symptoms of Kawasaki disease manifest in 3 distinct phases, with the first signs of heart problems showing up between 10 days-2 weeks after the initial symptoms:

1^st Phase:

Known as the acute phase, the following symptoms generally persist for 1-2 weeks with treatment:

• A fever higher than 102 F and lasting between 3-5 days with, and as many as 11 days without treatment. It is usually unresponsive to generic fever-reducing medication like ibuprofen.
• Conjunctivitis, i.e. red and swollen eye whites without a thick discharge and minimal to no pain.
• Hard, red, painful, and tender skin of the fingers, toes, palms, and foot soles that makes it difficult to put weight on them. It may be visible in toddlers as a reluctance to walk or crawl in toddlers with the condition.
• Swollen lymph nodes in the neck (usually on one side) and other parts of the body.
• A red, swollen, ‘strawberry’ tongue
• Red, dry, and cracked lips
• Torso and genital rash.
• Irritability

2^nd Phase:

The symptoms generally become milder and the fever subsides in the sub-acute phase within 3-4 weeks of treatment and diagnosis. Significant pain and irritability may still remain, with other symptoms being:

• Peeling of skin on the hands and feet, often in large sheets particularly at the toes and fingertips
• Jaundice (yellow eye whites and skin)
• Swollen and painful joints
• Temporary hearing loss
• Enlarged gallbladder
• Pus-containing urine
• Abdominal pain
• Headaches
• Vomiting
• Lethargy
• Diarrhea

3^rd Phase (Weeks 5-6):

Also known as the recovery phase, the symptoms gradually fade between week 4 and 6, provided that no complications develop. Although lethargy usually takes 8 weeks to wear off completely during which time the child may appear less physically active and tire easily.

Complications:

Although most children recover from the condition unharmed within a few weeks, around 25% of those affected develop the following cardiac complications despite treatment. However, the chances of these complications being fatal is less than 2%.

• Dysrhythmia (abnormal heart rhythm)
• Myocarditis (heart muscle inflammation)
• Mitral Regurgitation (damage to the heart valves)
• Vasculitis (coronary artery inflammation)
• Aneurysms (weakness and bulging in the artery walls) commonly resulting from vasculitis. Aneurysms increase the risk of artery blockages, internal bleeding, and even a heart attack.

Consider a possible case of Kawasaki if your child’s fever is higher than 102 F for more than 3 days and is accompanied by 2 or more of the above symptoms, consult your doctor immediately for a prompt diagnosis and treatment. You can also book an appointment with a top Rheumatologist in Lahore, Karachi and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your child’s health concerns.