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Kawasaki Disease: Symptoms, Diagnosis and Treatment

Kawasaki disease is a rare condition in children that involves inflammation of the blood vessels.

Kawasaki disease (KD), also known as Kawasaki syndrome, lymph node syndrome andmucocutaneous lymph node syndrome, is anautoimmune disease in which the medium-sized blood vessels throughout the body become inflamed. It is largely seen in children under five years of age. It affects many organ systems, mainly those including the blood vessels, skin, mucous membranes, and lymph nodes.

What are the symptoms of Kowasaki disease?

Kawasaki disease often begins with a high and persistent fever that is not very responsive to normal treatment with paracetamol(acetaminophen) or ibuprofen.

Other symptoms often include:

  • Extremely bloodshot or red eyes (without pus or drainage)
  • Bright red, chapped, or cracked lips
  • Red mucous membranes in the mouth
  • Strawberry tongue, white coating on the tongue, or prominent red bumps on the back of the tongue
  • Red palms of the hands and the soles of the feet
  • Swollen hands and feet
  • Skin rashes on the middle of the body, NOT blister-like
  • Peeling skin in the genital area, hands, and feet (especially around the nails, palms, and soles)
  • Swollen lymph nodes (frequently only one lymph node is swollen), particularly in the neck area
  • Joint pain and swelling, frequently on both sides of the body

Diagnosis of Kawasaki Disease

No tests specifically diagnose Kawasaki disease. The diagnosis is usually made based on the patient having most of the classic symptoms.

However, some children may have a fever lasting more than 5 days, but not all of the classic symptoms of the disease. These children may be diagnosed with atypical Kawasaki disease. Therefore, all children with fever lasting more than 5 days should be evaluated, with Kawasaki disease considered as a possibility. Early treatment is essential for those who do have the disease.

The following tests may be performed:

  • Chest x-ray
  • Complete blood count
  • Echocardiogram
  • Electrocardiogram
  • ESR
  • Serum albumin
  • Serum transaminase
  • Urinalysis – may show pus in the urine or protein in the urine

Procedures such as ECG and echocardiography may reveal signs of myocarditis, pericarditis, arthritis, aseptic meningitis, and inflammation of the coronary arteries.

Treatment for Kawasaki Disease

Intravenous gamma globulin is the standard treatment. It is given in high doses. The child’s condition usually greatly improves within 24 hours of treatment with IV gamma globulin. High-dose aspirin is often given along with IV gamma globulin.

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