Kawasaki disease is the most common cause of acquired heart disease in children. It affects about 7,000 children in the United States every year. Although most with Kawasaki disease are younger than 5 years, it can occur in children of all ages and even in young adults.
Kawasaki disease is a rare syndrome of unknown origin that causes high fever, reddening of the eyes (conjunctivitis), lips and mucous membrane of the mouth, gingivitis (ulcerative gum disease), swollen neck glands and a bright red rash over the skin of the hands and feet, in young children.
Kawasaki disease causes inflammation in the walls of arteries throughout the body, including the coronary arteries, which supply blood to the heart muscle. As it affects the lymph nodes, skin, and mucous membranes inside the nose, mouth and throat it is also called mucocutaneous lymph node syndrome.
Kawasaki disease is more common in boys than girls. It was first diagnosed by Tomiraku Kawasaki, a Japanese doctor in 1967, hence the name. Kawasaki disease has nothing to do with motorbikes or motorbike accidents.
Causes
Although Kawasaki disease can occur in community outbreaks, particularly in the winter and early spring, no one knows the cause. The peak age of occurrence in the United States is between six months and five years.
Infection – The symptoms of Kawasaki disease are similar to those of an infection. This means that bacteria or a virus may be responsible. However, so far, a bacterial or viral cause hasn’t been identified. As Kawasaki disease isn’t contagious, it can’t be passed from one person to another. Therefore, it is unlikely to be caused by a virus alone.
Genetics – The children who develop Kawasaki disease may be genetically predisposed to it. This means that the genes they inherit from their parents may make them more likely to get the condition. One theory is that rather than there being a single gene responsible for Kawasaki disease, it may be the result of many genes that each slightly increase the chances of a child developing the condition.
Others – One theory is that Kawasaki disease may be an autoimmune condition (where the immune system attacks healthy tissues and organs). Other theories suggest Kawasaki disease may be a reaction to certain medications, or environmental pollutants such as chemicals or toxins (poisons).
Risk Factors
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 descent, such as Japanese or Korean, have higher rates of Kawasaki disease.
Symptoms
Major Signs and Symptoms
One of the main symptoms during the early part of Kawasaki disease, called the acute phase, is fever. The fever lasts longer than 5 days. It remains high even after treatment with standard childhood fever medicines.
Other classic signs of the disease are –
- Swollen lymph nodes in the neck
- A rash on the mid-section of the body and in the genital area
- Red, dry, cracked lips and a red, swollen tongue
- Red, swollen palms of the hands and soles of the feet
- Redness of the eyes
Other symptoms that may develop include –
- arthritis-like symptoms (joint pain and swelling of the joints)
- extreme irritability
- diarrhea
- vomiting
- abdominal pain
- enlarged liver or gallbladder
- cough and respiratory symptoms
Kawasaki and Autism – Studies reported that there is a statistically significant association between Kawasaki disease and the diagnosis of an autistic disorder. Population-based claims database, tested the hypothesis that Kawasaki disease may increase the risk of autism.
Complications
Even though complications are very rare, when they do occur they can be serious, and on some occasions fatal.
Aneurysm – the blood vessels leading to the heart can become inflamed, causing a section of the artery wall to weaken and bulge outwards. If the aneurysm does not heal itself a blood clot can form, which raises the risk of a heart attack or internal bleeding if the aneurysm bursts.
The following complications from Kawasaki disease are also possible:
- Myocarditis – inflammation of the myocardium (heart muscle).
- Pericarditis – inflammation of the pericardium (lining around the heart).
- Arrhythmia – irregular heart beat.
- Cardiomegaly – the heart becomes larger than normal as a result of heart disease.
- Mitral regurgitation – blood flows back from the left ventricle to the left atrium of the heart due to a valve problem (blood flows back when it shouldn’t).
Treatment
Medications – Two main medicines for Kawasaki disease treatment:
- Aspirin – children under 16 should not be given aspirin. However, it is prescribed if a child has Kawasaki disease. Children with Kawasaki disease have a very high blood platelet count, making them very susceptible to blood clots forming in their bloodstream. Aspirin helps prevent blood clots, as well as reducing the fever, rash and joint inflammation.
- Gammaglobulin – these are cells in the blood which help fight infection (antibodies). Gammaglobulin is administered intravenously (through a vein in the child’s arm). Symptoms tend to improve rapidly; within 24 hours of administering gammaglobulin.
Coronary artery angioplasty – this procedure opens up an artery that has narrowed by inflating a small balloon inside the artery which squashes a clot against the wall of the blood vessel.
Stent – a stent may be placed in the clogged artery to help prop it open, reducing the risk of it becoming blocked again. A stent placement is often done along with an angioplasty.
Coronary artery bypass graft – blood flow is rerouted round a diseased coronary artery by grafting a section of blood vessel from the chest, arm or leg to use as the alternate route. The bypass effectively goes around the blocked area of the artery, allowing blood to pass through into the heart muscle.
Alternative Treatment
Copper Supplements – Copper is essential to all living organisms and is a universally important cofactor for many hundreds of metalloenzynes. Copper deficiency is widespread and appears in many forms . It leads to Kawasaki disease.
Reference –
http://www.aafp.org/afp/2006/1001/p1141.html
http://www.examiner.com/article/kawasaki-disease-syndrome
http://www.mayoclinic.org/diseases-conditions/kawasaki-disease/basics/risk-factors/con-20024663
https://www.nhlbi.nih.gov/health/health-topics/topics/kd/signs
http://www.kkh.com.sg/HealthPedia/Pages/ChildhoodIllnessesHeartKawasakiDisease.aspx
http://patient.info/health/kawasaki-disease-leaflet
http://arstechnica.com/science/2015/06/the-mystery-of-kawasaki-disease/