Kawasaki Disease – Symptoms, Diagnosis and Treatment
Those who have a child who has Kawasaki disease may feel like they’re not sure what to do about it. But there are things you can do. Read on to learn about the symptoms, diagnosis and treatment.
Initial therapy
Initially, Kawasaki disease treatment is directed toward decreasing inflammation, reducing fever and inhibiting platelet aggregation. In addition, it is also intended to prevent myocardial ischemic injury.
Initial therapy for Kawasaki disease should include an aspirin-containing regimen. A high-dose regimen is recommended to hasten the resolution of fever, whereas a lower-dose regimen has a slower anti-inflammatory effect. It is important to start treatment as early as possible to prevent the development of potentially life-threatening coronary artery abnormalities.
For patients who develop coronary artery abnormalities, intravenous gamma globulin therapy should be considered. This is because this drug may have a direct beneficial effect on abnormal cardiac function. It is expensive, however, and can have potential side effects.
Corticosteroids have been shown to reduce the incidence of coronary aneurysms in some studies. However, the timing of the use of corticosteroids in initial therapy for Kawasaki disease is uncertain. In a 3-year-old boy with Kawasaki disease, systemic corticosteroids were required in the first week of illness to control myocarditis. During the next 6 weeks, myocarditis subsided and myocardial infarction did not occur.
In patients with moderate-risk Kawasaki disease, the response rate to treatment was 72.5 per cent. This was compared to 77.6 per cent for high-risk patients. The rate of coronary artery lesions was 2.3 per cent in the low-risk group.
In the current recommendation, all children with Kawasaki disease should receive a high-dose aspirin regimen as soon as possible. The American Academy of Pediatrics recommends a C-reactive protein level of less than 3 mg/dL. A higher dose is required for older children. The CRP level should be monitored to ensure that the child does not develop abnormalities.
In addition to standard treatments, patients with Kawasaki disease can be treated with thrombolytics. These drugs are given in addition to standard treatments and should be administered in the ED. They can cause allergic complications in some patients.
Initial therapy for Kawasaki disease also includes oral acetylsalicylic acid and intravenous immune globulin. These are well-established therapies. But further studies are necessary to determine the etiopathogenesis of the disease and to establish the appropriate use of these medications.
Long-term therapy
Despite being the leading cause of acquired heart disease in children, Kawasaki disease can go undiagnosed and untreated. This can result in serious complications and even death.
Although the underlying causes of Kawasaki disease are still unknown, it has been associated with an increased rate of coronary artery aneurysms. In some cases, patients who receive a single dose of intravenous immune globulin (IVIG) are able to reduce their risk of developing coronary artery abnormalities. However, it is important to note that this treatment is only effective in the first ten days after a fever starts. In fact, studies have shown that approximately 1 per cent of Kawasaki disease patients develop coronary artery abnormalities after the initial course of treatment.
The most common symptom of Kawasaki disease is a high fever. Other symptoms include rash, erythema, and cervical lymphadenopathy. The standard of care is IVIG therapy, which is given in two grams per kilogram of body weight. In addition, patients should receive influenza vaccination.
The most important complication of Kawasaki disease is the development of aneurysms of the coronary arteries. In some cases, these abnormalities may occur as early as six to eight weeks after the onset of the illness. These arteries become thick and enlarged and can lead to sudden death. The incidence of coronary artery aneurysms is higher in children under one year of age. The frequency of visits to the cardiologist will depend on the degree of coronary changes.
For diagnosis, the cardiology team may order a physical exam, an electrocardiogram, and an echocardiogram. These tests should be done in a facility that specializes in examining the arteries of young children. If a diagnosis is made, the patient should be treated immediately.
The first line of therapy for Kawasaki disease is a single dose of intravenous immunoglobulin. This is administered in four daily doses and should be started within ten days of the onset of the fever.
Aside from the traditional IVIG, patients may also receive attenuated live virus vaccines. These can prevent the onset of a reduced specific immune response in patients who have previously received IVIG.
Diagnosis
Several techniques are being evaluated for the diagnosis of Kawasaki disease. One technique is called transthoracic echocardiography. The method involves an ultrasound method of viewing the heart. Depending on the severity of coronary artery damage, patients may be referred to a cardiology centre. A cardiologist will perform a history and physical exam, perform an electrocardiogram, and conduct an echocardiogram.
The most common complication of Kawasaki disease is an aneurysm of the coronary arteries. Usually, aneurysms are associated with a low risk of cardiac complications, but in cases where there is a high-risk, percutaneous intervention and/or surgery are required. In addition, there is a risk of coronary thrombosis. Therefore, treatment should be started as soon as possible.
Treatment of children with Kawasaki disease should be performed in conjunction with a pediatric rheumatologist. In addition, the diagnosis should be made as early as possible, because early detection can reduce the risk of coronary artery abnormalities.
The onset of fever and other symptoms of Kawasaki disease should be noted. These symptoms may occur at different times. When they do, notify your healthcare provider. Some of the symptoms are the same as those of juvenile idiopathic arthritis and measles. Other less common mimics include Rocky Mountain spotted fever and leptospirosis.
A blood sample is sometimes taken to check for platelet counts and C-reactive protein (CRP). These tests can be used to help diagnose the condition. If these tests do not confirm the diagnosis of Kawasaki disease, another test will be needed.
In addition, it is important to monitor a child’s heart over the long term to see if aneurysms develop or persist. The patient may require periodic cardiology evaluations, as well as procedures to restore arterial flow. Typically, these visits will be scheduled every six to twelve months. Depending on the extent of the coronary artery damage, the frequency of the visits will vary.
If your child has Kawasaki disease, it is important to follow up on a regular basis. If an aneurysm persists, the child will need to be treated with intravenous immunoglobulin. This procedure is most effective when started within the first 10 days of illness.
Symptoms
Symptoms of Kawasaki disease may include fever, swollen fingers and toes, painful joints, and diarrhoea. It may also lead to inflammation of blood vessels that supply the heart with blood. This inflammation can affect the heart muscle and arteries and can result in complications.
Most children with Kawasaki disease recover quickly, but some may experience long-term heart problems. These children will need to follow up with a pediatric cardiologist. They may need to take medication or have procedures done to prevent future heart problems. The risk of developing long-term heart problems increases with certain lifestyle habits, including smoking, obesity, and high cholesterol levels.
In addition, about 20 to 40 per cent of children with Kawasaki disease develop abnormalities in blood vessels in the heart muscle. This can cause blood clots or thrombosis. These abnormalities can lead to the rupture of a blood vessel and life-threatening conditions. These abnormalities can be prevented by treating the disease early.
The best time to treat Kawasaki disease is within the first 10 days of the symptoms. This is the time when a high dose of intravenous immunoglobulin (IVIG) will be most effective. These large amounts of IVIG will help to reduce the risk of coronary artery aneurysms and damage to the heart. These treatments will require the patient to stay in the hospital for several days.
The most important thing to do is to contact your healthcare provider if your child has been experiencing any of the symptoms of Kawasaki disease. Your healthcare provider will perform a physical exam and may order a chest X-ray or abdominal ultrasound. Your doctor will ask you to describe your child’s health history. He or she will then perform an echocardiogram, a painless test that shows the heart. If your doctor finds that your child has an abnormality on the echocardiogram, he or she will have to repeat it to look for any more changes.
Some children with Kawasaki disease may also need to be treated with corticosteroids. They may also need to be on blood thinning medication or have surgery. If the heart problems are severe, the child will need to go back to the hospital to have an electrocardiogram.