Kawasaki Disease

kawasaki diseaseKawasaki Disease is an illness that involves the skin, mouth, and lymph nodes. The disease usually begins with a fever unresponsive to tylenol or aspirin which continues for at least 7 - 10 days. Many but not all children develop a swollen area on the neck which looks like an infection. Some researchers believe it is an infection, others an autoimmune disorder stimulated by an infection or exposure to an environmental toxin. The disease is seen more often in the winter and spring seasons. Kawasaki disease, or mucocutaneous lymph node syndrome, is a disease of unknown etiology that most frequently (80% of the time) affects infants and children under five years of age. Some doctors think it may be caused by a virus or a bacteria. The illness can last from 2 weeks to a few months. Originally, KD was believed to be an acute, self-limiting febrile disease with an excellent prognosis; however, subsequent reports indicated that nearly 2% of patients with KD died from the illness, usually as a result of secondary cardiac sequelae. It was first noticed in Japanese children following World War II. No blood test for Kawasaki disease is available. The diagnosis is based on symptoms.
 
Kawasaki disease is a poorly understood illness. The male-to-female ratio among patients with Kawasaki disease is 1.5:1. Children of nearly all racial backgrounds are affected. Recurrences and cases in siblings are seen only occasionally. The most important part of Kawasaki disease is its tendency to cause inflammation of the coronary arteries which supply blood to the heart. Changes can be found on echocardiogram in about 15% of patients. The inflammation is uncomfortable, but resolves with time. However, the main threat from Kawasaki disease comes from its effect on the heart and blood vessels. Affected children develop red eyes, red mucous membranes in the mouth, red cracked lips, a "strawberry tongue" and swollen lymph nodes. Skin rashes occur early in the disease and peeling of the skin in the genital area, hands, and feet (especially around the nails and on the palms and soles) may occur in later phases. Kawasaki disease is a systemic vasculitis of unknown etiology that affects the small- and medium-sized blood vessels of the body, in particular, the coronary arteries. Early treatment is effective in preventing this, but first Kawasaki disease must be recognized.
 
Causes of Kawasaki disease
 
The common causes and risk factor`s of Kawasaki disease include the following:
 
The exect cause of Kawasaki Disease is unknown.
Abnormality of the immune system.
Some doctors think it may be caused by a virus or a bacteria. The illness can last from 2 weeks to a few months.
Other researchers believe that KD is caused by a unique bacterial toxin.
Several organisms have been investigated as the possible etiologic agents, as follows: mite-associated bacteria, tick-borne diseases, Rickettsia species, Propionibacterium acnes, and several viruses such as Epstein-Barr virus and retroviruses.
Additional risk factors in the United States include Asian race and male sex.
A small possible link with carpet shampoo or living near a body of stagnant water, but neither of these theories have yet been established.
Symptoms of Kawasaki disease
 
Some sign and symptoms related to Kawasaki disease are as follows:
 
Fever.
Swollen hands and feet.   
Diarrhea.
Vomiting.
Eye irritation (conjunctivitis) without pus.
Fretfulness.
Abdominal pain.
Palms of hands and soles of feet are red; skin starts to peel off fingers and toes about 2 weeks after illness starts.
A swollen lymph node ("gland") in the neck area.
A red rash.
Red eyes, without pus-like discharge.
Treatment of Kawasaki disease
 
Here is list of the methods for treating Kawasaki disease:
 
Kawasaki disease is treated with medications. Long-term care may be needed and might include continued medication, limited physical activity, and repeated testing.
Intravenous gamma globulin (IVIG) is the standard treatment for Kawasaki disease and is administered in high doses with marked improvement usually noted within 24 hours.
The child may also be given a high-dose of aspirin to reduce the risk of heart problems.
Corticosteroids have also been used with some success, especially when other treatments fail or symptoms recur, but have not usually been considered a first-line therapy.
Plasma Exchange ( Plasmapheresis ) has been reported as effective in patients who were not responding to aspirin and gamma globulin.