Is Kawasaki disease serious?

Written by Li Jiao Yan
Neonatology
Updated on September 08, 2024
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Kawasaki disease is an etiologically unclear disease with a not well-understood pathogenesis. The principal pathological change involves inflammatory changes in the systemic blood vessels, which can affect the coronary arteries and lead to coronary artery aneurysms and dilation. Kawasaki disease is self-limiting, and most cases resolve well, with recurrences seen in 1-2% of cases. For patients without coronary artery lesions, comprehensive examinations are required 1 month, 3 months, 6 months, and 1-2 years after discharge, including physical examinations, electrocardiograms, and echocardiograms, mainly to assess the heart's condition. If not effectively treated, 15-20% may develop coronary artery aneurysms; such cases need semi-annual or annual medical check-ups. Coronary artery aneurysms often self-resolve within two years post-diagnosis, typically leaving functional abnormalities such as thickening of the vessel wall and reduced elasticity. Major artery aneurysms often do not disappear completely and can lead to thrombosis or narrowing of the vessel lumen. Kawasaki disease is one of the common causes of acquired heart disease in children; therefore, if Kawasaki disease is accompanied by severe coronary damage, it may heal well but could lead to heart disease. If it is not a severe case of Kawasaki disease, timely treatment can still result in a good recovery.

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Written by Li Jiao Yan
Neonatology
1min 42sec home-news-image

Is Kawasaki disease scary?

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is a common pediatric autoimmune disease. The pathogenesis of Kawasaki disease remains unclear, and its etiology is also unknown, mainly focusing on immune reactions, genetic susceptibility, and theories of pathogenic microbial infections. Its primary pathological change is systemic vasculitis, most commonly affecting the coronary arteries. Most cases of Kawasaki disease have a good prognosis, with recurrences seen in 1% to 2% of patients. After effective treatment, complications involving coronary artery damage are less common. However, untreated patients develop coronary artery aneurysms in 15%-25% of cases. These aneurysms often resolve on their own within two years of the illness, but often leave behind complications such as thickened vessel walls and reduced elasticity. Large aneurysms are less likely to resolve completely and often lead to thrombosis or narrowing of the vessel lumen. Kawasaki disease is also one of the common causes of acquired heart disease in children. Thus, if Kawasaki disease is detected early, timely treatment is necessary to avoid cardiac sequelae. After effective treatment, the prognosis is generally good. However, if there are complications like coronary artery damage or other heart issues, it may affect the child's quality of life and even lifespan.

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Written by Li Jiao Yan
Neonatology
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Is the spirit of Kawasaki disease good?

Kawasaki disease, also known as mucocutaneous lymph node syndrome, has an unclear cause and is generally prevalent in infants and young children, with 80% of cases occurring in children under five years old. The mechanism of the disease is also not very clear. Its main pathological presentation is systemic vasculitis, often involving the coronary arteries. The primary clinical symptoms include high fever, which is unresponsive to antibiotic treatment, conjunctival congestion, diffuse oral congestion, strawberry tongue, indurative edema of the hands and feet, and palmoplantar erythema. Additionally, it may affect the heart, leading to conditions such as pericarditis, myocarditis, endocarditis, and arrhythmias. During the acute phase of Kawasaki disease, the high fever and diffuse oral mucosal congestion can affect the child's mental state. If the heart is involved, there may be abnormalities in heart rate and heart function, which can also lead to a poor mental state. Therefore, if Kawasaki disease is confirmed, it definitely requires active treatment.

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Written by Li Jiao Yan
Neonatology
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What is Kawasaki Disease?

Kawasaki disease was first reported in 1967 by Tomisaku Kawasaki in Japan and is also known as mucocutaneous lymph node syndrome. Approximately 15% to 20% of cases experience coronary artery damage after effective treatment. Since 1970, cases have been reported worldwide, with a higher incidence among Asians. As diagnostic capabilities improve globally, the incidence of this disease is decreasing. This disease occurs sporadically or in small epidemics and can occur in any season, most commonly affecting infants and young children, with 80% of cases occurring in children under five years of age. The cause of the disease is unclear, and the mechanism of onset is also not well understood, with the primary pathological change being systemic vasculitis. The main clinical symptoms are high fever between 39 to 40 degrees Celsius, followed by ineffectiveness of antibiotic treatment, and conjunctival congestion. Other symptoms include congested, cracked lips, diffuse congestion of the oral mucosa, indurative edema of hands and feet with emerging erythema, polymorphous skin eruptions and scarlet fever-like rash, and enlarged cervical lymph nodes, which can be unilateral or bilateral, hard and tender, but not red on the surface. There may be complications involving coronary artery damage, and potential complications such as myocarditis, pericarditis, endocarditis, and arrhythmias. Additionally, there may be other associated symptoms such as interstitial pneumonia, digestive system symptoms, joint pain, and arthritis.

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Written by Li Jiao Yan
Neonatology
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How many days does it take to be discharged from the hospital for Kawasaki disease?

Kawasaki disease is a disease with unclear pathogenesis and etiology. A major pathological change is systemic vasculitis, which commonly affects the coronary arteries. Typically, it presents with fever lasting from seven to fourteen days or longer, and antibiotics are ineffective in treatment. During the first through sixth weeks of the illness, complications such as pericarditis, myocarditis, endocarditis, and arrhythmias may occur. Coronary artery damage often occurs between the second and fourth weeks of the illness, and proactive and effective treatment of Kawasaki disease can prevent coronary complications. The acute phase generally involves symptomatic supportive care, prevention of platelet aggregation, fever reduction, and prevention of coronary artery damage. Treatment with intravenous immunoglobulin is recommended within the first ten days of onset. If the treatment is not effective, other special medications like steroids may be used, and the treatment duration is generally between two to four weeks. Thus, the pathogenesis of Kawasaki disease is uncertain, and its pathological process is prolonged. The specific timing of discharge depends on the child's condition. If the fever is controlled and no significant coronary artery damage is evident, and the condition is stable, then discharge is possible. However, post-discharge, follow-up should be conducted based on the child's specific condition. Therefore, the duration of hospitalization for Kawasaki disease is not fixed and depends on the child's condition and treatment response.

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Written by Yan Xin Liang
Pediatrics
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Kawasaki disease sequelae

Kawasaki disease is an autoimmune vasculitis, and since it is vasculitis, it can originate from blood vessels in various parts, including the heart, liver, kidneys, brain, and more. However, it mainly arises from the coronary arteries of the heart. If Kawasaki disease is not effectively treated, some patients can develop coronary artery dilation and even coronary artery aneurysms. Once a coronary artery aneurysm occurs, its complication includes the risk of rupture and bleeding of the aneurysm, which can be difficult to treat if there is severe bleeding. If there is some coronary artery dilation, it can lead to the formation of coronary artery thrombosis, which is also a complication it can cause. However, the vast majority of Kawasaki disease cases, if treated effectively, can prevent coronary artery abnormalities. Therefore, as long as the treatment is timely, most cases will not have significant lasting effects.