Kawasaki Disease
Other Names: Mucocutaneous Lymph Node Syndrome, Infantile
Polyarteritis
Kawasaki's Disease is a rare, childhood
autoimmune that attacks the walls of blood vessels
causing them to inflame and reduce the amount of blood
flow. It can attack any blood vessel: veins, arteries
and capillaries. In most cases children can make a
full recovery with proper treatment, however Kawasaki's
can cause serious complications when main vessels
and coronary arteries are affected.
Symptoms of Kawasaki's might include a high fever,
swollen lymph nodes in the neck, rashes in the genital
area and across the trunk, swollen tongue, red and
dry, cracked lips and redness in the eyes. Kawasaki's
can also affect the lymph nodes, skin and mucous membranes
(mouth, nose and throat).
According to the Mayo
Clinic* there are three stages to Kawasaki Disease.
First phase
Signs and symptoms of the first phase may include:
• Fever,
which often is higher than 101.3 F (38.5 C), and lasts
one to two weeks
• Extremely
red eyes (conjunctivitis) without 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
Second phase
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
• Diarrhea
• Vomiting
• Abdominal
pain
Third phase
In the third phase of the disease, signs and symptoms
slowly go away unless complications develop.
Symptoms:
Bright red mouth, also known as strawberry mouth
Fever
General redness and inflammation of the skin
Irritability
Lips that are red and cracked
Red eyes
Skin peeling on fingers, hands,feet or genital area
Swelling in ankles
Swelling in hands and fingers
Swelling in legs
Swollen eyes
Swollen lymph nodes
Diagnosis:
Typically Kawasaki's is diagnosed through a process
of eliminating other possible causes of the symptoms,
a review of symptoms, medical history and risk factors.
Chest X-rays may be performed to help rule out other
causes, and a urinalysis may show some abnormalities
as well. EKG's and Echocardiograms are used to determine
heart function to help in the diagnosis. Blood tests
may show:
Elevated C-Reactive Protein (CRP)
Elevated Erythrocyte Sedimentation Rate (ESR)
Low Albumin
Low Total Serum Iron
Treatment:
The goal of treatment is to lower the immediate fever
(if present) and lower the inflammation to reduce
heart complications and improve the quality of life
for the patient. Gamma Globulin infusion is a common
form of therapy used to lower the risk of coronary
artery problems. Aspirin is also used to prevent blotting.
Close monitoring of the heart is a long-term part
of the treatment process to detect any signs of complications
as early as possible.
Prognosis:
With early detection and treatment, the progress
is very good with most making a full recovery. However,
there is a 1% death rate when the condition is not
properly treated or complications become sever enough
to cause inflammation of the heart muscle (myocarditis),
heart valve problems (mitral regurgitation), abnormal
heart rhythm (arrhythmia) or inflammation of blood
vessels (vasculitis), usually the coronary arteries,
which supply blood to the heart. When these complications
are not identified early enough to be treated, the
prognosis is poorer.
|
