A prolonged fever during which the heart and blood vessels may be damaged
- More common under the age of 5
- Slightly more common in boys
- More common in Asian and black people
- Lifestyle is not a significant factor
First observed in Japan in the 1960s, Kawasaki disease is a rare condition in which a prolonged fever is associated with damage to the heart and blood vessels. In the UK, fewer than 1 in every 25,000 children under the age of 5 are affected each year. The disorder is now being diagnosed more often in Western countries, and it occurs more frequently in Asian and black people. Heart damage occurs in about 1 in 5 of all cases of Kawasaki disease. Early diagnosis is very important because the condition can become life-threatening.
The cause of Kawasaki disease is not known, although it is suspected that a viral or bacterial infection may be involved. However, despite a great deal of research, there is as yet no conclusive evidence to confirm this theory.
What are the symptoms?
The symptoms develop over about 2 weeks and may include:
Prolonged, constant high fever that lasts more than 5 days.
Sore or itchy eyes and redness of the white of the eye (see Conjunctivitis).
Cracked, painful, and swollen lips.
Reddening of the mouth and throat.
A blotchy red rash.
Swollen glands, especially in the neck.
Reddening of the palms of the hands and soles of the feet, usually followed by peeling skin on the tips of the fingers and toes.
Kawasaki disease may lead to serious complications. For example, balloon-like swellings, called aneurysms, can develop in the walls of the coronary arteries, which supply the heart muscle. Inflammation of the heart muscle (see Myocarditis) may also occur. Kawasaki disease can also damage blood vessels throughout the body.
What might be done?
Diagnosis of Kawasaki disease can be difficult because the symptoms are very similar to those of minor viral infections, such as the common cold. You should consult a doctor if your child develops a fever that cannot be lowered by taking paracetamol and other simple self-help measures (see Bringing down a fever). If Kawasaki disease is suspected, your child will be admitted to hospital immediately because treatment is most effective if started within 10 days of the onset of the disease. Your child will probably have blood tests to look for evidence of Kawasaki disease. The imaging technique echocardiography may also be carried out to look for damage to the heart muscle and coronary blood vessels.
If Kawasaki disease is confirmed, the child will probably be given intravenous immunoglobulin. This substance is a blood product containing antibodies that fight infection. Immunoglobulin also reduces the risk of aneurysms and inflammation of the heart muscle in Kawasaki disease for reasons that are not fully understood. High doses of aspirin are usually prescribed until the fever subsides. Lower doses are then continued over a period of several weeks.
What is the prognosis?
Most children who have Kawasaki disease recover completely within 3 weeks but need regular follow-up visits, and possibly echocardiography, over the next few months. Aneurysms and myocarditis, if present, usually disappear over a period of several months. Kawasaki disease is fatal in about 1 in 100 affected children. In children who survive, there is a small risk of developing coronary artery disease later in life.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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