Kawasaki Disease: Symptoms, Diagnosis, Treatment

Kawasaki disease is a rare but serious medical condition that causes the inflammation of blood vessels (vasculitis), predominantly in children below the age of five. Inflamed blood can lead to complications in the blood vessels that supply blood to the heart. 

Kawasaki disease is not contagious, but it is potentially life-threatening in 2 to 3% of cases.

What are the symptoms of Kawasaki disease?

Kawasaki disease typically progresses through three stages (acute, subacute and convalescent) within about six weeks, during which symptoms gradually manifest. The cardinal features of Kawasaki disease are:

• Fever for at least five days.
• Red or pink eyes.
• Swollen, bumpy, red tongue (strawberry tongue).
• Redness and/or swelling of the lips, mouth, and throat.
• Redness and/or swelling of the hands and feet.
• Swollen lymph nodes in the neck region.
• Rashes that start in the genital area. It can also extend to the back, abdomen, chest, arms and legs. 

What are the risk factors?

The cause of Kawasaki disease is unclear. However, several risk factors have been identified.

Children who develop Kawasaki disease may have a genetic predisposition to it, meaning that the genes they inherit from their parents could increase their susceptibility to the condition.

How is Kawasaki disease diagnosed?

There is no specific test to diagnose Kawasaki disease, but certain signs can indicate the condition. A child may have Kawasaki disease if they have a fever lasting five days or more, along with at least 4 of the 5 key symptoms as listed:

• Conjunctival infection in both eyes.
• Changes to the mouth or throat – swollen lips, strawberry tongue.
• Changes to the hands and feet – swollen hands or feet.
• Polymorphous rashes.
• Cervical lymphadenopathy – swollen lymph nodes in the neck region.

When Kawasaki disease is suspected in children, the following tests are commonly performed:

1. Blood test
   • Complete blood counts with differential white blood cell (WBC) counts.
   • Liver function tests, including aspartate transaminase (AST), alanine transaminase (ALT), and albumin levels.
   • C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
2. Urinalysis
3. Echocardiography
   • Uses high-frequency sound waves to create images of the heart’s structure and function. An echocardiogram can confirm if there are any abnormalities or problems with the heart’s structure or function.

How is it treated?

Treatment aims to reduce inflammation and prevent or minimise damage to blood vessels and heart complications.

Treatment includes:

• Intravenous immunoglobulin (IVIG)
• Aspirin (for fever and to prevent blood clots)

What are the potential complications?

Complications of Kawasaki disease include:

• Aneurysms (a weakened, bulging part of an artery, like a bulge in a balloon)
• Kawasaki disease shock syndrome (KDSS)
• Abnormal heart rhythm (arrhythmia)
• Coronary artery stenosis or occlusion
• Disseminated intravascular coagulopathy 
• Thrombosis 
• Kidney disease
• Heart attack

Children who receive appropriate treatment for Kawasaki disease and do not develop aneurysms usually achieve complete recovery without needing extensive ongoing monitoring. However, their return to normal health may take around one to two months, during which adequate rest is crucial.

For children diagnosed with Kawasaki disease who do develop aneurysms, they need to undergo continuous follow-up care with a cardiologist. 

How to prevent Kawasaki disease?

Preventing Kawasaki disease is not currently possible. However, if diagnosed and treated promptly, children have the potential to fully recover within 6 to 8 weeks. Nevertheless, there is a risk of complications emerging. Hence, it is crucial to promptly seek medical attention and initiate treatment as soon as symptoms arise.

Book an appointment at Pantai Hospitals

Kawasaki disease is a rare but potentially life-threatening condition. Early diagnosis and immediate intervention are vital for optimal recovery with minimal long-term complications. 

A dedicated and expert team of Paediatricians at Pantai Hospitals is available for consultation to provide the best care and assistance. Get in touch with us to book an appointment today if you have concerns or questions regarding Kawasaki disease. We assure you the best possible care tailored to your specific needs.

Pantai Hospitals has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.