Learn more about this condition that primarily affects young children and causes inflammation in the walls of the arteries throughout the body.
Kawasaki disease causes swelling (inflammation) in children in the walls of small to medium-sized blood vessels that carry blood throughout the body. Kawasaki disease commonly leads to inflammation of the coronary arteries, which supply oxygen-rich blood to the heart.
Kawasaki disease was previously called mucocutaneous lymph node syndrome because it also causes swelling in glands (lymph nodes) and mucous membranes inside the mouth, nose, eyes and throat.
Children with Kawasaki disease might have high fever, swollen hands and feet with skin peeling, and red eyes and tongue. But Kawasaki disease is usually treatable, and most children recover without serious problems if they receive treatment within 10 days of onset.
To receive a diagnosis of Kawasaki disease, a child usually will have a fever greater than 102.2 F (39 C) for five or more days and at least four of the following signs and symptoms.
The symptoms might not occur at the same time, so it's important to let your child's health care provider know about a sign or symptom that has gone away.
Other signs and symptoms that might develop include:
Children with a high fever for five or more days who have fewer than four of the above signs and symptoms might have what's known as incomplete Kawasaki disease. Children with incomplete Kawasaki disease are still at risk of coronary artery injury and still require treatment within 10 days of the onset of symptoms.
Kawasaki disease can have symptoms similar to that of multisystem inflammatory syndrome in children, which has occurred worldwide in children with COVID-19. Children with these symptoms will likely be checked for COVID-19, as well.
If your child has a fever that lasts more than three days, contact your child's health care provider. Treating Kawasaki disease within 10 days of when it began may greatly reduce the chances of lasting damage to the coronary arteries supplying the heart muscle.
No one knows what causes Kawasaki disease, but scientists don't believe the disease is contagious from person to person. Some think that Kawasaki disease happens after a bacterial or viral infection, or that it's linked to other environmental factors. Certain genes might make children more likely to get Kawasaki disease.
Three things are known to increase a child's risk of developing Kawasaki disease.
Kawasaki disease tends to occur seasonally. In North America, it usually occurs in the winter and early spring.
Kawasaki disease is a leading cause of acquired heart disease in children in developed countries. However, with treatment, few children have lasting damage.
Heart complications include:
Any of these complications can damage the heart. Inflammation of the coronary arteries can lead to weakening and bulging of the artery wall (aneurysm). Aneurysms increase the risk of blood clots, which could lead to a heart attack or cause life-threatening internal bleeding.
For a small percentage of children who develop coronary artery problems, Kawasaki disease can cause death.
There's no specific test available to diagnose Kawasaki disease. Diagnosis involves ruling out other diseases that cause similar signs and symptoms, including:
The health care provider will do a physical examination and order blood and urine tests to help in the diagnosis. Tests might include:
To reduce the risk of long-term complications, your child's health care provider will want to begin treatment for Kawasaki disease as soon as possible, preferably while your child still has a fever. The goals of initial treatment are to lower fever and inflammation and prevent heart damage.
Treatment for Kawasaki disease can include:
Aspirin. High doses of aspirin might help treat inflammation. Aspirin can also decrease pain, joint inflammation and fever. The aspirin dose will likely be lowered once the fever has been gone for 48 hours.
Kawasaki treatment is a rare exception to the rule that says aspirin shouldn't be given to children. Aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in children recovering from chickenpox or flu. Children with Kawasaki disease should be given aspirin only under the supervision of a health care provider.
Because of the risk of serious complications, initial treatment for Kawasaki disease is usually given in a hospital where doctors can continue to monitor the child.
Once the fever goes down, a child might need to take low-dose aspirin for at least six weeks — longer if he or she develops a coronary artery aneurysm. Aspirin helps prevent blood clotting.
However, children who develop flu or chickenpox during treatment might need to stop taking aspirin. Taking aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition that can affect the blood, liver and brain of children and teenagers after a viral infection.
With treatment, a child might start to improve soon after the first gamma globulin treatment. Without treatment, Kawasaki disease lasts about 12 days. However, heart complications might last longer.
If your child has any signs of heart problems, the health care provider might recommend follow-up tests to check your child's heart health at regular intervals, often at 6 to 8 weeks after the illness began, and then again after six months.
If heart problems continue, your child might be referred to a doctor who specializes in treating heart disease in children (pediatric cardiologist). Treatment for heart complications related to Kawasaki disease depends on the type of heart condition.
If your child was given gamma globulin, it's a good idea to wait at least 11 months to get a live vaccine, such as the chickenpox or measles vaccine, because gamma globulin can affect how well these vaccinations work. Tell your child's health care provider that your child has had Kawasaki disease.
Find out all you can about Kawasaki disease so that you can make informed choices with your child's health care team about treatment options.
Most children with Kawasaki disease recover completely. Generally, children who have been treated for Kawasaki get well fast and return to normal activities. If your child's heart has been affected, talk to the pediatric cardiologist about whether activity restriction is needed.
You'll probably first see your family health care provider or pediatrician. Sometimes a child may also be referred to a doctor who specializes in treating children with heart conditions (pediatric cardiologist), a doctor who specializes in treating children with bone and joint disorders (rheumatologist), or one who specializes in treating children with infectious diseases.
Here's some information to help you get ready for your appointment.
Bring a family member or friend to the appointment, if possible, to help you remember all the information you're given.
Make a list of:
For Kawasaki disease, some questions to ask your child's health care professional include:
Don't hesitate to ask additional questions.
Your child's health care provider is likely to ask you questions, such as:
November 18th, 2021