Kawasaki Disease: Causes, Symptoms, Treatment, Prognosis

Kawasaki Disease is a pathological condition which causes inflammation of the arteries throughout the body which also includes the coronary artery which is a very important artery as it provides blood to the heart muscle. Kawasaki Disease also affects the lymph nodes and the mucous membranes inside the mouth, nose, throat, and also affects the skin.

The presenting features of Kawasaki Disease are extremely high fever and a peeling skin. Fortunately, Kawasaki Disease is a disease condition which is absolutely treatable and in majority of cases people suffering from Kawasaki Disease have complete recovery without any form of serious complications.

There is no known cause for Kawasaki Disease but researchers blame it to certain bacteria, virus or other environmental pathogens as to the cause for the development of Kawasaki Disease but it has not been proved as of yet. Kawasaki Disease is not a contagious condition and does not spread from person to person. Some researchers are also of the opinion that certain genes may increase an individual’s risk for developing Kawasaki Disease more than others.

The symptoms of Kawasaki Disease present themselves basically in three phases and the symptoms delineated below are divided into the two phases of Kawasaki Disease. These symptoms are:

The symptoms experienced by the patient during the first phase of Kawasaki Disease are:

• Fever higher than 102.2 F lasting for about a week
• Conjunctivitis
• Rashes in the trunk or the genital areas
• Dry and cracked lips
• Erythematous and swollen tongue
• Swollen and erythematous skin on the palms of the hands and the soles of the feet
• Lymph node swelling of the neck
• Severe irritability.

The symptoms of the second phase of Kawasaki Disease are:

• Peeling of the skin on the hands and feet
• Joint pains
• Diarrhea
• Vomiting
• Abdominal pain.

During the third the phase of Kawasaki Disease, the symptoms start to improve and go away slowly it may take around two months before the individual returns back to normal.

There is no one test which can definitively diagnose Kawasaki Disease and diagnosis is made basically by excluding or ruling out other diseases that may cause similar symptoms such as scarlet fever, juvenile rheumatoid arthritis, measles or rocky mountain spotted fever. Apart from this, the patient may need to undergo certain laboratory investigations to further conclude the diagnosis of Kawasaki Disease. These tests are:

Urinalysis to identify and rule out infections or other disease processes causing similar symptoms

Blood Tests are important because if it shows presence of elevated while blood cell counts and presence of anemia then it may point decisively towards a diagnosis of Kawasaki Disease.

An echocardiogram may be done to check the status of the coronary arteries as Kawasaki Disease affects the coronary arteries and if the patient has Kawasaki Disease then there will be abnormalities in the study since the coronary arteries will be affected thus confirming the diagnosis of Kawasaki Disease.

Once the diagnosis of Kawasaki Disease is confirmed, it is important to start treatment emergently so as to avoid any potential complications due to this condition. The initial treatment will comprise of bringing the temperature down and treating the fever and prevent any form of heart damage due to the compromised state of the coronary arteries. The treatment modalities for Kawasaki Disease are:

• Infusion of gamma globulin intravenously will bring down the risk for coronary artery problems significantly.
• Inflammation will be treated with high doses of aspirin. It is also quite helpful in decreasing fever and joint pains caused due to Kawasaki Disease.
• Once the fever is controlled and the patient becomes somewhat normal, he or she will be placed on a dose of aspirin preferably for a period of six weeks minimum; however, aspirin is not recommended for patients who develop conditions like herpes zoster infection or flu during treatment as it may lead to complications.

Without any treatment, Kawasaki Disease lasts for about two weeks although there may be a risk for heart complications due to the compromised state of the coronary arteries which may become evident later in life but with treatment the improvement in condition may be seen immediately after gamma globulin is given and with careful heart monitoring a complete recovery within a week is possible.

In case there are signs of a heart problem due to Kawasaki Disease, then the doctor may recommend regular followups for monitoring the heart condition at regular intervals even after complete recovery from Kawasaki Disease. If the condition of the heart does not improve then the patient will be referred to a cardiologist for more aggressive treatment and may require the following:

• Anticoagulant medications to prevent any clot formation
• Coronary artery angioplasty, which is a surgical procedure in which the arteries are widened so that blood may flow through them smoothly
• Stent Placement. In some cases, this procedure may be done to widen the narrowed artery by placing a stent
• Coronary Artery Bypass Graft is a procedure in which the diseased coronary artery is bypassed by grafting a section of blood vessel from the leg, chest or arm so that blood can pass through this route.

Early diagnosis and treatment of Kawasaki Disease usually resolves the condition within two months of the start of the treatment. With treatment there is also a marked decrease in the risk of any coronary artery abnormality or heart problems. If treatment is not able to be rendered for Kawasaki Disease, then also the condition may resolve in a few weeks although the risk of coronary artery disease or heart damage remains there. There is always a chance of a relapse of Kawasaki Disease after initial treatment and for such cases the patient needs to be readmitted to the hospital and the treatment should be restarted to treat Kawasaki Disease.