What Is Kawasaki Disease And How Is It Treated

Kawasaki Research Foundation

In this article, we are going to learn what is Kawasaki disease and how it is treated. Kawasaki Disease (KD) is a rare and potentially fatal illness affecting children. KD occurs worldwide but is most commonly seen in Japan, where it affects about 1 out of 100,000 people each year. In the United States, KD is less than 1 percent of cases.

Treatment of Kawasaki disease. 

Treatment of KD consists of intravenous immunoglobulin (IVIG), aspirin, and supportive care. IVIG is recommended for all cases of KD regardless of the presence of coronary artery lesions. Aspirin is recommended for all patients who have a persistent fever after receiving IVIG. Supportive care includes monitoring of vital signs, fluid replacement, nutritional support, and pain control. 

This is just for knowledge and educational purposes only. Do not take any drug without the advice of your doctor. I the owner of this site is not a doctor. So, taking any type of medication after reading our content may cause serious damage to your health.

Symptoms of  Kawasaki disease.

Symptoms of Kawasaki disease may appear suddenly over several days or weeks. Symptoms may include fever, rash, conjunctivitis (red eyes), swollen hands and feet, red tongue, and stomach pain. These symptoms may occur alone or together. Other symptoms may include headache, irritability, vomiting, diarrhea, cough, and chest pain. Most patients recover completely without treatment. However, some patients develop coronary artery abnormalities that can lead to heart problems. 

 First case of  Kawasaki disease.

In Japan, KD was first described in 1967 and is now recognized worldwide. The etiology of KD remains unknown. However, epidemiological studies have suggested that KD may be associated with infectious agents. Recent evidence suggests that KD is triggered by an environmental factor(s). 

Prevention of Kawasaki disease. 

The best way to prevent KD is to avoid the spreading of GABHS bacteria. If you have been exposed to GABHS, wash your hands frequently with soap and water. Avoid sharing drinks, food, eating utensils, toys, or clothing with others. Clean surfaces regularly. Keep your child away from anyone who is sick. Call your doctor if your child develops any of these symptoms:

• Fever lasting longer than 5 days

• Rash

• Swollen hands and/or feet

• Redness of the face, lips, tongue, or inner cheeks

• Fast breathing

• Cough

• Vomiting

• Diarrhea

• Stomach pain

If your child has any of these symptoms, call your doctor right away. Early diagnosis and treatment can help reduce the risk of complications. 

Causes of  Kawasaki disease 

There is currently no consensus regarding the cause of  Kawasaki disease. However, several hypotheses exist. These include infectious agents, genetic factors, environmental triggers, and immunologic mechanisms.

Infectious Agents

Several viruses have been implicated in the pathogenesis of KD. Among them, human herpesvirus 6 (HHV-6), cytomegalovirus (CMV), Epstein-Barr virus (EBV), parainfluenza virus type 3 (PIV-3), adenovirus, and enteroviruses have been reported to be associated with KD. HHV-6 was first isolated from the blood of a patient who had KD in 1986. 

Since then, numerous reports have demonstrated the association of HHV-6 with KD. A study conducted in Japan showed that HHV-6 DNA was detected in the peripheral blood mononuclear cells (PBMCs) of patients with KD. This suggests that HHV-6 might play a role in the pathogenesis of the disease. Some experts believe that  KD is caused by infection with group A beta-hemolytic streptococci (GABHS), bacteria.  

A number of case series have suggested that CMV is associated with KD. One Japanese study showed that CMV IgM antibodies were positive in 40% of patients with KD, compared to only 4% of controls. Another study conducted in Taiwan showed that CMV DNA was detectable in PBMCs of patients with KD. Furthermore, a prospective study conducted in Japan demonstrated that the detection of CMV DNA in PBMCs was significantly higher among patients with KD than among those without KD.

Although EBV has not been consistently linked to KD, some studies suggest that EBV may be involved in the pathogenesis of this disorder. A study conducted in Korea showed that EBV DNA was detected in PBMCs of 8 out of 11 patients with KD, compared with none of the control subjects.

Parainfluenza virus type 2 (PIV-2) has also been implicated in the pathophysiology of KD. PIV-2 RNA was detected in nasopharyngeal aspirates of patients with KD in a study conducted in Japan. Other investigators have also reported the isolation of PIV-2 from the respiratory tract of patients with KD.

Adenovirus has been proposed as a possible trigger of KD. An epidemiologic study conducted in Japan showed an increased risk of KD after the introduction of a vaccine containing live attenuated adenovirus serotype 35.

Environmental Triggers

Some researchers believe that KD is triggered by an environmental factor, rather than by a viral agent. A study conducted in Italy showed that KD occurred more frequently in spring and summer months, when the prevalence of KD is highest. The authors hypothesized that KD could be caused by an unidentified environmental factor that increases susceptibility to KD in susceptible individuals.

Immunologic Mechanisms

An alternative hypothesis suggests that KD results from an abnormality in the immune system. Several investigators have postulated that KD is mediated by an aberrant T-cell response directed against an antigen(s). A study conducted in Japan demonstrated elevated levels of interferon-gamma (IFN-γ) in the serum of patients with KD. This indicates that IFN-γ may play a role in the immunopathogenesis of KD.

Another group of investigators has suggested that KD is induced by an autoimmune mechanism. One theory proposes that an antibody directed against an autoantigen causes vascular damage. A study conducted in China showed that anti-endothelial cell antibodies were present in the serum of patients who developed  Kawasaki disease.

Diagnosis of Kawasaki disease 

The clinical features of KD are nonspecific, making diagnosis difficult. The American Heart Association recommends.  Patients with suspected KD should undergo laboratory testing. These include complete blood count, C-reactive protein level, and erythrocyte sedimentation rate. 

It also includes serum electrolytes. liver function tests urinalysis, chest radiography, electrocardiogram, echocardiogram, and coronary artery evaluation. However, these investigations do not always provide definitive diagnostic information. 

The incidence of  Kawasaki disease varies geographically and seasonally. The incidences peak between January and April each year. KD affects approximately 1 in 1000 children worldwide and is more prevalent in Japan than in any other country. 

However, recent studies have shown that the incidence of KD in the United States is increasing at a rate similar to that observed in Japan. After reading this article you not only know what is Kawasaki disease and how it is treated but all the necessary details about Kawasaki disease.