Encyclopedia of Health and Medicine

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Kawasaki disease An acute condition affecting
children that can weaken the CORONARY ARTERIES
and other cardiovascular structures, resulting in
HEART ATTACK, ANEURYSM, or permanent damage.
Kawasaki disease, also called mucocutaneous
LYMPH NODE syndrome, comes on suddenly with
RASH, FEVER, CONJUNCTIVITIS, and swollen lymph
nodes (LYMPHADENOPATHY). The characteristic symptom
that raises suspicion the condition is more
than a typical viral INFECTION is the bright red color
of the lips and mucous membranes in the MOUTH.
After about five days the palms of the hands and
soles of the feet also become bright red. The child
appears, and is, very ill. The acute phase of the
disease runs about three weeks. The diagnostic
path is primarily clinical; there are no definitive
tests for Kawasaki disease.
Treatment during the acute phase includes
efforts to keep the child comfortable as well as
administering high-DOSE aspirin. Aspirin, not usually
given to children who have fevers because of
the risk for REYE’S SYNDROME, is the treatment of
choice for Kawasaki disease because it not only
reduces FEVER but also reduces cardiovascular
INFLAMMATION and has antiplatelet action that helps
prevent blood clots from forming. These effects
lower the likelihood of cardiovascular damage or
crisis. Intravenous IMMUNOGLOBULIN, which delivers
generalized antibodies that aid the body’s IMMUNE
RESPONSE, given early in the course of the disease
seems to mitigate symptoms in some children.
Sometimes cardiovascular symptoms manifest
during the disease’s acute phase, though typically
it is months to years later that problems become
apparent. Doctors recommend cardiovascular
assessment, including ELECTROCARDIOGRAM (ECG)
and ECHOCARDIOGRAM, for children at the time of
diagnosis. Detected cardiovascular changes require
regular followup, with treatment as necessary. The
most serious long-term consequences of Kawasaki
disease are aneurysms of the coronary arteries
that cause heart attack. In some children, inflammation
attacks the heart valves, resulting in VALVU-
LAR HEART DISEASE that requires ongoing medical
attention and sometimes heart valve replacement
in adulthood.
Doctors believe an infectious agent, such as a
VIRUS, likely causes Kawasaki disease though as yet
researchers have been unable to isolate it. Though
occasionally there appear to be clusters of
Kawasaki disease, the condition does not appear
to be contagious through contact among family
members and close contacts. Children under five
years of age are most likely to develop Kawasaki
disease. Children who have had Kawasaki disease
rarely get it again.
See also ANTIBODY; SCARLET FEVER; TOXIC SHOCK
SYNDROME.
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