Kawasaki disease
Kawasaki disease, also known as Kawasaki syndrome or mucocutaneous lymph node syndrome, is an inflammatory illness that primarily affects children under the age of five. Although its exact cause remains unknown, it is believed to possibly stem from an allergic reaction, a viral or bacterial infection, or an immune system response. The disease is characterized by a persistent high fever, a patchy rash, and redness in the lips, mouth, and throat, along with swollen lymph nodes in the neck and extremities. Additional symptoms may include diarrhea, vomiting, stomach pain, joint pain, irritability, and skin peeling on the fingers and toes.
Kawasaki disease can lead to serious complications, particularly affecting the heart and blood vessels, and may result in long-term heart damage if not treated promptly. Treatments typically involve medications like aspirin and gamma globulin to manage symptoms and reduce the risk of heart problems. Early diagnosis and treatment within the first ten days can significantly improve prognosis, as less than 25% of patients experience heart issues when treated on time. The disease was first identified by Dr. Tomisaku Kawasaki in 1967 and has since been recognized as a leading cause of acquired heart disease in young children in the United States.
Kawasaki disease
ALSO KNOWN AS: Kawasaki syndrome, mucocutaneous lymph node syndrome (MLNS)
ANATOMY OR SYSTEM AFFECTED: Brain, blood vessels, circulatory system, heart, immune system, lymphatic system, mouth, skin
DEFINITION: An inflammatory disease that affects numerous organs and systems in the body and typically occurs in children under the age of five
CAUSES: Unknown; possibly allergic reaction, viral or bacterial infection, or immune system response
SYMPTOMS: High fever; patchy rash; red lips, mouth, tongue, and throat; swollen lymph nodes in neck; swollen hands and feet; diarrhea; vomiting; stomach pain; joint pain; irritability; peeling skin on fingers and toes
DURATION: Two weeks to three months; long-term heart damage possible
TREATMENTS: Aspirin, gamma globulin
Causes and Symptoms
The exact cause of Kawasaki disease is unknown. According to Johns Hopkins Medicine in 2023, the victims are usually children under the age of 5. In the United States, the disease affects between 9 and 20 children out of 100,000 each year. Some doctors believe that the disease may be an allergic reaction to certain types of infection. Others think that it is produced by a virus or bacterium. Some researchers believe that the source is an interaction of T cells, white blood cells that help regulate the immune system’s response to infections, with toxins produced by bacteria.
Kawasaki disease begins rather abruptly with a fever that persists for five days or longer and can reach 104 degrees Fahrenheit. A red, patchy rash typically spreads over the chest and genital area and may cover the entire body. The lips, mouth, tongue, and throat become very red. The lymph nodes in the neck may be swollen, as well as the hands and feet. The hands, feet, eyes, and mucous membrane linings of the eyelids turn red. These symptoms may be accompanied by diarrhea, vomiting, stomach pain, joint pain, and irritability. As the fever subsides, there is a characteristic peeling of the skin from the fingers and toes. The symptoms associated with Kawasaki disease may last from two weeks up to three months.
Treatment and Therapy
Kawasaki disease should be treated as soon as it is diagnosed. A variety of prescribed medications may be used. Aspirin can reduce the fever, ease joint pain, and relieve the rash. A physician should be consulted about the risk of Reyes syndrome before giving aspirin to children and teens. Gamma globulin, purified antibodies found in blood, is administered intravenously to help fight infection and reduce the risk of the development of coronary artery abnormalities or damage to the heart muscle. If the disease is treated within ten days of its onset, then less than 25 percent of patients experience any heart problems.
A doctor may order an electrocardiogram (ECG or EKG), chest radiograph, and echocardiogram in order to monitor heart functions. If liver or gallbladder malfunction occurs, then ultrasonic imaging of those organs may be necessary.
Perspective and Prospects
Tomisaku Kawasaki first identified Kawasaki disease in 1967, when he reported the symptoms in fifty children in cases occurring between the years of 1961 and 1967. In children under five, the disease has become a leading cause of acquired heart disease in the United States, according to the Centers for Disease Control and Prevention (CDC). The Kawasaki Disease Foundation reports that about 6,000 children are diagnosed with Kawasaki disease in the United States each year and about 25 percent of them develop heart disease. Epidemics occurred in Japan in 1979, 1982, and 1985. Death from heart-related problems related to Kawasaki disease or reoccurence of the disease occur in a small percentage of patients.
Bibliography
"About Kawasaki Disease." Centers for Disease Control and Prevention, 29 May 2020, www.cdc.gov/kawasaki/about.html. Accessed 2 Apr. 2024.
Barnes, Benjamin Thea. "Kawasaki Disease." Johns Hopkins Medicine, 2023, www.hopkinsmedicine.org/health/conditions-and-diseases/kawasaki-disease. Accessed 2 Apr. 2024.
Hawker, Jeremy, et al. Communicable Disease Control and Health Protection Handbook. 3rd ed., Wiley, 2012.
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"Kawasaki Disease." MedlinePlus. US National Library of Medicine, 25 Oct. 2023, medlineplus.gov/kawasakidisease.html. Accessed 2 Apr. 2024.
Powell, Michael, and Oliver Fischer. 101 Diseases You Don’t Want to Get. Thunder’s Mouth, 2005.
Rowley, Anne H. "Kawasaki Disease." Principles and Practice of Pediatric Infectious Diseases, edited by Sarah S. Long, Larry K. Pickering, and Charles G. Prober, 4th ed., Saunders, 2012, pp. 1002–7.
"The Staggering Truth About Kawasaki Disease." Kawasaki Disease Foundation, www.kawasakikidsfoundation.org/. Accessed 3 Aug. 2023.
"What Is Kawasaki Disease?" Kawasaki Disease Foundation, kdfoundation.org/what-is-kawasaki-disease/. Accessed 2 Apr. 2024.