What is Kawasaki Disease?

Written by Li Jiao Yan
Neonatology
Updated on September 02, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Li Jiao Yan
Neonatology
1min 50sec home-news-image

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.

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

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.

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

Does Kawasaki disease rash itch?

Kawasaki disease, once called mucocutaneous lymph node syndrome, is a disease of unknown cause and unclear pathogenesis. It is characterized by systemic vasculitis. Clinically, it mainly presents with fever, conjunctival congestion, cracked lips, congested oral mucosa, diffuse congestion, strawberry tongue, acute stage swelling and erythema of the hands and feet, polymorphous rash, and scarlet fever-like skin rash. It is often associated with unilateral or bilateral lymphadenopathy, which is not red on the surface, but the lymph nodes are hard and tender to the touch. It frequently involves complications such as myocarditis or pericarditis, with common coronary artery damage. The rash seen in Kawasaki disease is a manifestation of vasculitis and is generally non-itchy.

doctor image
home-news-image
Written by Yan Xin Liang
Pediatrics
59sec home-news-image

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.

doctor image
home-news-image
Written by Shi Ji Peng
Pediatrics
45sec home-news-image

How long does Kawasaki disease require hospitalization?

Kawasaki disease requires hospitalization and continued medication after discharge. The duration of the hospital stay is mainly determined by the child's clinical symptoms. The child can return home when the fever subsides and the dosage of aspirin is reduced, which may take about four to seven days, although this is just a general scenario. After discharge, medication must continue. If the child's coronary arteries are fine, with no dilation or lesions, a low dose of aspirin can be taken for about two months. If there are issues with the coronary arteries, aspirin must be continuously taken until the dilation resolves before stopping the aspirin, so this period can be quite long.