Childhood Diseases – On a Mission to Educate: Kawasaki Disease

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My last article, ”Childhood Diseases – On a Mission to Educate: Reye’s Syndrome“ we learned that Reye’s is a rare but very serious illness that usually occurs in children. It can affect all organs of the body but it mostly affects the brain and the liver. Reye’s usually occurs after a viral infection, most commonly chickenpox or influenza. No one actually knows what causes it but there is a strong correlation to the use of aspirin or aspirin containing medications during viral infections. Some symptoms of Reye’s Syndrome are vomiting, irritability or aggressiveness, confusion, lethargy, seizures & coma. There is no cure for Reye’s Syndrome however if there is quick and early medical intervention, symptoms can be managed with better outcomes. Today I would like to move onto another childhood illness called Kawasaki Disease.

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What Is Kawasaki Disease?

According to the National Institutes of Health (https://www.nhlbi.nih.gov/health/health-topics/topics/kd) Kawasaki Disease is a rare childhood disease that affects the blood vessels causing them to become inflamed. This process is called Vasculitis which is a condition where the immune system attacks the blood vessels by mistake, causing inflammation of these vessels. Kawasaki disease can “affect any blood vessel in the body including arteries, veins and capillaries.” Unfortunately it can also affect the coronary arteries thereby affecting the heart.

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Kawasaki disease is named after Dr. Tomisaku Kawasaki, a Japanese pediatrician in Japan who was the first to identify the condition. According to AAP News & Journals (http://pediatrics.aappublications.org/content/106/2/e27) Dr. Kawasaki published his first report about Kawasaki Disease in Japanese in 1967 but in 1974 he published the first English report of 50 patients with Kawasaki Disease. Since this time Kawasaki Disease has become the leading cause of acquired heart disease among children in North America and Japan according to AAP News & Journals.

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What Causes Kawasaki Disease?

The exact cause of Kawasaki disease is still unknown according to Health Line (https://www.healthline.com/health/kawasaki-disease#symptoms2). Researchers believe that the cause can be a mixture of genetics and environmental factors. The reason for this is because Kawasaki Disease occurs during specific seasons and tends to affect children of Asian descent.

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Kawasaki Disease Symptoms

Stanford Children’s Hospital (http://www.stanfordchildrens.org/en/topic/default?id=kawasaki-disease-90-P01801) stated that the most common symptoms of Kawasaki disease is as follow:

• Moderate-to-high fever (101.0° F to 104.0° F [38.3°C to 40.0°C]) that lasts for at least five days

• Irritability

• Swollen lymph glands in the neck

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• Spotty, bright red rash on the back, chest, abdomen, and/or groin

• Bloodshot eyes

• Sensitivity to light

• Swollen, coated tongue

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• Dry, red, cracked lips

• Red, swollen palms of hands and soles of feet

• Peeling skin around the nail beds, hands, or feet

• Swollen, painful joints

Kawasaki disease generally lasts 10 to 14 days but each child may experience symptoms differently. It should also be noted that the above symptoms may look like other conditions or medical problems so parents should consult the child’s physician as soon as possible.

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How Is Kawasaki Disease Diagnosed

Because Kawasaki disease can look similar to other common childhood viral and bacterial illnesses, there is no single test that can detect it. Doctors usually diagnose Kawasaki disease by examining the symptoms and then ruling out other conditions. Kids Health (http://kidshealth.org/en/parents/kawasaki.html#) stated that most children diagnosed with Kawasaki disease will have a fever lasting five or more days and have at least four of the following symptoms: redness in both eyes, changes around the lips, tongue, or mouth, changes in the fingers and toes (swelling, peeling, color change), rash in the chest, stomach or genital area, a large swollen lymph node in the neck or red, swollen, palms of hands and soles of the feet.

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Stanford Children’s Hospital listed the following diagnostic tests that may also be conducted to diagnose Kawasaki disease:

• Electrocardiogram (ECG). A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.

• Echocardiogram (echo). A procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves.

• X-ray. A diagnostic test which uses invisible X-ray energy beams to produce images of internal tissues, bones, and organs onto film.

• Complete blood count (CBC). A measurement of size, number, and maturity of different blood cells in a specific volume of blood. The health care provider will look for an elevation in the numbers of white blood cells which normally multiply in the presence of infection and may notice elevated platelet levels with Kawasaki disease as well.

• Erythrocyte sedimentation rate (ESR or sed rate). A measurement of how quickly red blood cells fall to the bottom of a test tube. When swelling and inflammation are present, the blood's proteins clump together and become heavier than normal. Thus, when measured, they fall and settle faster at the bottom of the test tube. Generally, the faster the blood cells fall, the more severe the inflammation.

• Urinalysis. Testing of a urine sample for protein, red blood cells, white blood cells, or casts to indicate kidney disease associated with several rheumatic diseases.

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Treatment For Kawasaki Disease

Children diagnosed with Kawasaki Disease are admitted to the hospital. According to Healthy Children.org (https://www.healthychildren.org/English/health-issues/conditions/heart/Pages/Kawasaki-Disease.aspx) “the medication used to treat Kawasaki Disease in the hospital is called gamma globulin (IVIG). IVIG is given through an IV over 8 to 12 hours. Children may be given aspirin, as well, to lower the risk of heart problems. Children stay in the hospital for at least 24 hours after completing the IVIG dose to make sure the fever does not return and other symptoms are improving.”

If a child does not respond well to the above, additional treatments may be necessary, especially if the fever returns and they find abnormal Echocardiogram results. “Another dose of IVIG or other medications that fight inflammation such as steroids, infliximab, or etanercept may be recommended.”

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What Are the Complications For Kawasaki Disease?

If Kawasaki Disease is left untreated, it can lead to very serious complications such as inflammation of the blood vessels. Healthy Children.org stated that inflammation of blood vessels can be dangerous because the coronary arteries, which supply blood to the heart, can be affected. Another danger is that Aneurysms can also develop which is a condition where there is a ballooning out of damaged and weaken blood vessels. Fortunately if treatment is implemented within the first 10 days of Kawasaki disease, the risk of getting aneurysms decreases significantly. That is why it is important that the child is diagnosed before the ten days are up. Timely medical intervention is vital.

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Major Facts About Kawasaki Disease?

Per Healthy Children.org the following are some basic facts about Kawasaki Disease:

• 80% to 90% of Kawasaki Disease cases occur in children under age 5 and older than 6 months.

• Kawasaki Disease is not contagious. It does not spread among family members or children in child care centers.

• Kawasaki Disease occurs more frequently in those of Asian ancestry.

• The cause of Kawasaki Disease is not known, but it is thought to be a reaction by the body's immune system.

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Additional facts according to National Institutes of Health (https://www.nhlbi.nih.gov/health/health-topics/topics/kd) are:

• Kawasaki disease affects children of all races and ages and both genders. It occurs most often in children of Asian and Pacific Island descent. The disease is more likely to affect boys than girls. Most cases occur in children younger than 5 years old.

• One of the main symptoms of Kawasaki disease is a fever that lasts longer than 5 days. The fever remains high even after treatment with standard childhood fever medicines.

• Children who have the disease also may have red eyes, red lips, and redness on the palms of their hands and soles of their feet. These are all signs of inflamed blood vessels.

• Early treatment helps reduce the risk of Kawasaki disease affecting the coronary arteries and causing serious problems.

• Kawasaki disease can't be prevented. However, most children who have the disease usually recover within weeks of getting symptoms. Further problems are rare.

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How does Kawasaki Disease Affect the Heart?

According to CHF (http://www.chfed.org.uk/how-we-help/information-service/heart-conditions/kawasaki-disease/) Kawasaki disease can affect the heart in the following ways:

• Coronary artery aneurysms

• Leakage of valves

• Accumulation of fluid around the heart (called pericardial effusion).

CHF stated that the most serious of these complications are the coronary artery aneurysms, where the blood vessels becomes dilated and swollen. So when the artery is dilated, the blood flows more slowly because it is at a lower pressure. This change in pressure and speed makes it easier for blood clots for form which in turn can increase the risk for a heart attack. Per CHF “In time, the coronary artery aneurysms may heal. Problems can also happen at this stage because the healed sections may be narrower than the rest of the artery (stenosis).”

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Final Information For Parents to Know About Kawasaki Disease

A final thing for parents to know is that Kawasaki Disease Symptoms are similar to symptoms of the following illnesses according to Health Line:

• Scarlet fever, a bacterial infection that causes fever, chills, and sore throat

• Juvenile rheumatoid arthritis, a chronic disease that causes joint pain and inflammation

• Measles

• Toxic shock syndrome

• Idiopathic juvenile arthritis

• Juvenile mercury poisoning

• Medical reaction

• Rocky Mountain spotted fever, a tick-borne illness

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In conclusion Kawasaki Disease is an acute childhood illness that causes inflammation of the blood vessels in many areas of the body. We learned that if it is not diagnosed and treated early, it can cause damage to the coronary arteries which supply the heart with oxygen. Most children with Kawasaki disease will have a fever lasting five or more days, redness in both eyes, changes around the lips, tongue or mouth, swelling, peeling and color changes in the fingers and toes, a rash, large swollen lymph node in the neck and red, swollen palms of the hands and soles of the feet. Most children who have the disease usually recover if treated early.

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I hope you learned something from this article about Kawasaki Disease. There are many resources on the internet if you need more specific information. I will continue this series with another childhood disease post. I hope you will continue to join me in this quest to learn about these illnesses that children usually encounter when they are young. Thank-you for reading my article on ”Childhood Diseases – On a Mission to Educate: Kawasaki Disease”. If you would like to follow me, please check HERE

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These are my previous articles. if you are interested in reading it:

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https://steemit.com/steemiteducation/@cabbagepatch/neuroplasticity-cognitive-behavior-therapy-cbt

Neuroplasticity: Mindfulness Based Cognitive Therapy
https://steemit.com/steemiteducation/@cabbagepatch/neuroplasticity-mindfulness-based-cognitive-therapy

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