Disease: Kawasaki disease
Kawasaki disease causes inflammation in the walls of medium-sized arteries throughout the body. It primarily affects children. The inflammation tends to affect the coronary arteries, which supply blood to the heart muscle.
Kawasaki disease is sometimes called mucocutaneous lymph node syndrome because it also affects lymph nodes, skin, and the mucous membranes inside the mouth, nose and throat.
Signs of Kawasaki disease, such as a high fever and peeling skin, can be frightening. The good news is that Kawasaki disease is usually treatable, and most children recover from Kawasaki disease without serious problems.
Kawasaki disease care at Mayo Clinic
Kawasaki disease symptoms usually appear in three phases.
Signs and symptoms of the first phase may include:
- A fever that is often is higher than 102.2 F (39 C) and lasts more than three days
- Extremely red eyes (conjunctivitis) without a thick discharge
- A rash on the main part of the body (trunk) and in the genital area
- Red, dry, cracked lips and an extremely red, swollen tongue (strawberry tongue)
- Swollen, red skin on the palms of the hands and the soles of the feet
- Swollen lymph nodes in the neck and perhaps elsewhere
In the second phase of the disease, your child may develop:
- Peeling of the skin on the hands and feet, especially the tips of the fingers and toes, often in large sheets
- Joint pain
- Abdominal pain
In the third phase of the disease, signs and symptoms slowly go away unless complications develop. It may be as long as eight weeks before energy levels seem normal again.
When to see a doctor
If your child has a fever that lasts more than three days, contact your child's doctor, or see your child's doctor if your child has a fever along with four or more of the following signs and symptoms:
- Redness in both eyes
- A very red, swollen tongue
- Redness of the palms or soles
- Skin peeling
- A rash
- Swollen lymph nodes
Treating Kawasaki disease within 10 days of its onset may greatly reduce the chances of lasting damage.
No one knows what causes Kawasaki disease, but scientists don't believe the disease is contagious from person to person. A number of theories link the disease to bacteria, viruses or other environmental factors, but none has been proved. Certain genes may increase your child's susceptibility to Kawasaki disease.
There's no specific test available to diagnose Kawasaki disease. Diagnosis largely is a process of ruling out diseases that cause similar signs and symptoms, including:
- Scarlet fever, which is caused by streptococcal bacteria and results in fever, rash, chills and sore throat
- Juvenile rheumatoid arthritis
- Stevens-Johnson syndrome, a disorder of the mucous membranes
- Toxic shock syndrome
- Certain tick-borne illnesses, such as Rocky Mountain spotted fever
The doctor will do a physical examination and have your child take other tests to help in the diagnosis. These tests may include:
- Urine tests. These tests help rule out other diseases.
Blood tests. Besides helping to rule out other diseases, blood tests look at white blood cell count, which is likely to be elevated, and the presence of anemia and inflammation, indications of Kawasaki disease.
Testing for a substance called B-type natriuretic peptide (BNP) that's released when the heart is under stress may be helpful in diagnosing Kawasaki disease earlier, recent research found. But, more research is needed to confirm this finding.
- Electrocardiogram. This test uses electrodes attached to the skin to measure the electrical impulses of your child's heartbeat. Kawasaki disease can cause heart rhythm complications.
- Echocardiogram. This test uses ultrasound images to show how well the heart is functioning and can help identify coronary artery abnormalities, if present.
Kawasaki disease is a leading cause of acquired heart disease in children, but with effective treatment, only a small percentage of children have lasting damage.
Heart complications include:
- Inflammation of blood vessels (vasculitis), usually the coronary arteries, that supply blood to the heart
- Inflammation of the heart muscle (myocarditis)
- Heart valve problems
Any of these complications can damage your child's heart. Inflammation of the coronary arteries can lead to weakening and bulging of the artery wall (aneurysm). Aneurysms increase the risk of blood clots forming and blocking the artery, which could lead to a heart attack or cause life-threatening internal bleeding.
For a very small percentage of children who develop coronary artery problems, Kawasaki disease is fatal, even with treatment.
Coping and support
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. Keep in mind that most children with Kawasaki disease recover completely, though it may be a little while before your child is back to normal and not feeling so tired and irritable. The Kawasaki Disease Foundation offers trained support volunteers to families currently dealing with the disease.
Three things are known to increase your child's risk of developing Kawasaki disease, including:
- Age. Children under 5 years old are most at risk of Kawasaki disease.
- Sex. Boys are slightly more likely than girls are to develop Kawasaki disease.
- Ethnicity. Children of Asian or Pacific Island descent, such as Japanese or Korean, have higher rates of Kawasaki disease.
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