Kawasaki disease is an acute systemic vasculitis that mainly affects patients under five years of age. It is the most prominent cause of childhood acquired coronary artery disease. Kawasaki disease causes swelling (inflammation) in children of the walls of the small to medium-sized blood vessels that carry blood throughout the body. Kawasaki disease usually causes inflammation of the coronary arteries, which supply oxygen-rich blood to the heart.
In addition to its effect on the arteries, Kawasaki disease also affects the lymph nodes, so it is often called the syndrome of lymph nodes, skin, and mucous membranes of the mouth, nose, and throat. Children with Kawasaki disease may have a high fever, swollen hands and feet with peeling skin, and red eyes and tongue.
Symptom
Symptoms of Kawasaki disease A child will usually have a fever of more than 102.2 F (39 C) for five days or more and at least four of the following signs and symptoms, a rash on the main body or in the genital area, enlarged lymph nodes in the neck, very red eyes without a thick discharge, red, dry, cracked lips and a very red swollen tongue, red skin on the palms of the hands and soles of the feet, which then peels off the skin on the fingers and toes, coughing, vomiting, diarrhea, stomachache, joint pain. Kawasaki disease can have symptoms similar to the multisystem inflammatory syndrome in children, which has occurred worldwide in children with COVID-19.
Causes
No one knows what causes Kawasaki disease. It is possible that Kawasaki disease occurs after a bacterial or viral infection, or is associated with other environmental factors. Certain genes may make children more likely to get Kawasaki disease.
Risk factors
Predisposing risk factors such as age (especially <6 months and >9 years), gender, boys are slightly more likely than girls to develop Kawasaki disease. Asian and Pacific Islander races, and Hispanic ethnicity have poor clinical outcomes.
Diagnosis
There is no specific test to diagnose Kawasaki disease. Diagnosis of other diseases that cause similar signs and symptoms, including scarlet fever, disease caused by streptococcal bacteria and causing fever, rash, chills, and sore throat, juvenile rheumatoid arthritis, Stevens-Johnson syndrome, disorders of the mucous membranes, toxic shock syndrome, measles, certain tick-borne diseases, such as Rocky Mountain spotted fever.
The AHA Criteria (2004) include suggestions for laboratory tests such as blood tests to check blood cell counts. A high white blood cell count and the presence of anemia and inflammation are signs of Kawasaki disease and early echocardiography is helpful in diagnosing incomplete KD such as Electrocardiogram and Echocardiogram. Consultation with an expert (cardiologist, immunologist, or rheumatologist).
Treatment
Treatment for Kawasaki disease may include, Gamma globulin, Infusion of immune protein (gamma globulin) through a vein (intravenous) can lower the risk of coronary arteries and help reduce inflammation in the blood vessels. Several treatment options have been suggested for treatment which include additional IVIG, corticosteroids, cyclosporine A, and cytokine blocking strategies.
Source: Ho-Chang Kuo. Kawasaki Disease: An Update on Diagnosis and Treatment. Pediatrics and Neonatology (2012) 53, 4e11.
https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/symptoms-causes/syc-20354598
https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/diagnosis-treatment/drc-20354603
AARON SAGUIL. Diagnosis and Management of Kawasaki Disease. American Family Physician. Volume 91, Number 6. March 15, 2015
Christian M. Hedrich. Kawasaki Disease. Frontiers in Pediatrics. July 2018 .Volume 6.
Source Picture: https://www.babyinfo.com.au/newborn/complications/hand-foot-and-mouth-disease/