What is Kawasaki disease?

Written by Li Jiao Yan
Neonatology
Updated on September 19, 2024
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Kawasaki disease is a disease possibly related to viruses. Currently, the exact cause of Kawasaki disease is unclear, and the mechanism of its onset is also not well understood. It is characterized primarily by systemic vasculitis and is an acute febrile exanthematous disease. Clinically, it presents with symptoms such as rash, fever, conjunctival congestion, cracked lips, oral mucosal congestion, enlarged cervical lymph nodes, and peeling of the skin on the extremities. The cause of Kawasaki disease is unclear, but various viral infections observed clinically could potentially exacerbate the progression of Kawasaki disease. It mainly affects the coronary arteries, so there is a certain link between Kawasaki disease and viruses. However, it is not necessarily the direct cause of Kawasaki disease but could worsen or be a concomitant disease.

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Written by Li Jiao Yan
Neonatology
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Is Kawasaki disease serious?

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 Yao Li Qin
Pediatrics
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Kawasaki disease causes

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is an immune-mediated systemic vasculitis syndrome and a relatively common pediatric febrile rash disease. To date, the etiology of Kawasaki disease is not entirely clear. Extensive epidemiological and clinical observations suggest that Kawasaki disease may be an acute immune dysregulation caused by infectious factors. Genetic factors are also related to the occurrence of Kawasaki disease. Various bacteria, viruses, mycoplasma, and their metabolic products, such as superantigens produced by Streptococcus and Staphylococcus, are also related to the development of Kawasaki disease.

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Written by Zeng Hai Jiang
Pediatrics
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Kawasaki Disease and Purpura Differences

The clinical manifestations of Kawasaki disease include fever lasting more than five days, ineffective antibiotic treatment, rashes, transient swelling of the cervical lymph nodes, conjunctival congestion, strawberry tongue, cracked lips, hard swelling of fingers and toes, and desquamation around the nails and anal region during the recovery phase. Allergic purpura is mainly manifested by rashes, which are generally hemorrhagic rashes below the buttocks, symmetrical on the lower limbs, raised above the skin surface, and usually without fever. Besides rashes, allergic purpura can also involve joint pain, abdominal pain, or allergic purpuric nephritis among other conditions.

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Written by Li Jiao Yan
Neonatology
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Why do children get Kawasaki disease?

Kawasaki disease has an unclear pathogenesis. It is speculated that it may be related to infections by microorganisms or other pathogens, familial genetic susceptibility, or autoimmune functions. Currently, the entire medical history is unclear, and there is no specific epidemiology identified for the onset of the disease; it can occur in any of the four seasons. The disease primarily affects infants and young children, with about 80% of cases occurring in children under five years of age. The ratio of male to female incidence is approximately 1.5:1. Thus, Kawasaki disease is most commonly seen in infants and young children. Currently, there is no definitive explanation for the mechanism of the disease.

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Written by Li Jiao Yan
Neonatology
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How many days can Kawasaki disease be cured?

Kawasaki disease is a syndrome of mucocutaneous lymph node syndrome, the cause of which is unclear, as is the pathogenesis of the disease. The pathological changes are mainly systemic vasculitis, which is prone to secondary damage to the coronary arteries. It has a relatively long course. If fever occurs, the fever can persist for 1-2 weeks. Generally, special medications such as aspirin are required for treatment. Usually, treatment is for 3 days, and after the fever subsides, the dosage is gradually reduced, maintained for 6-8 weeks. If there is secondary coronary artery damage, the duration might be longer. In cases of severe coronary damage, the duration of the disease may be several months or even years, depending on the specific condition of the disease. Kawasaki disease is a self-limiting disease. Usually, if there is no significant coronary artery damage, after symptom control, comprehensive examinations are conducted 1 month, 3 months, 6 months, and 1-2 years after discharge, mainly heart examinations such as electrocardiograms and echocardiograms. If there is a combination of coronary artery aneurysms, long-term follow-up is required, with an examination every six months to one year until the coronary aneurysm disappears or if there is combined damage to the coronary artery structure, long-term follow-up is needed.