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Kawasaki Disease

Kawasaki disease is one of the most common forms of vasculitis (a condition involving inflammation of blood vessels,) that affect young children. The cause of Kawasaki disease is unknown, although many theories have been discussed. It is not contagious, but it does occasionally occur in epidemics, primarily affecting children under the age of three. Occurrence beyond late childhood is extremely rare. The most worrisome part of Kawasaki disease is it can cause inflammation of the coronary arteries, which supply blood to the heart. Though rare, the coronary artery inflammation can be serious or even fatal, which is why Kawasaki disease requires prompt diagnosis and treatment by a physician.

Symptoms and Diagnosis

Kawasaki disease usually begins with prolonged high fever lasting for at least five days. In addition to the fever, children classically develop a variety of other symptoms caused by acute inflammation, and these help doctors make the diagnosis. These symptoms include:

  • Dry, cracked lips or other changes of the mouth or tongue
  • Red eyes
  • Extremity changes, including swelling of the hands and feet or redness of the palms and soles
  • Rashes

In children with Kawasaki disease, the diagnosis is suspected based purely on clinical signs and symptoms. The possibility of Kawasaki disease should be considered in any child with prolonged fever lasting more than five days without another likely explanation. Blood and urine tests may be helpful in making the diagnosis and ruling out other causes. All children with suspected Kawasaki disease should have an evaluation by a cardiologist as soon as possible with an electrocardiogram (EKG and) echocardiogram performed to determine if there is coronary artery involvement.

Treatment for Kawasaki Disease

Kawasaki disease is treated with a medication called intravenous immune globulin (IVIG). This medication is usually administered in a hospital. Treatment with IVIG is usually very effective in stopping the fever and inflammation of Kawasaki disease, and in limiting cardiac involvement when given early on in the course of the disease. It is rare for a child not to improve with IVIG. However, some children require two treatments or additional immunosuppressive medications, including steroids. In addition to IVIG, Kawasaki disease is treated with aspirin, usually for several months. Children require long-term follow up with a cardiologist, particularly if the  heart was affected by the disease. Most children with Kawasaki disease recover completely following prompt diagnosis and treatment.

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