What is Kawasaki disease and how is it dangerous

What is Kawasaki disease

Kawasaki Disease is an acute inflammation of the blood vessels, a type of vasculitis. The phenomenon was first described by Japanese pediatrician Tomisaku Kawasaki Kawasaki Disease: A Brief History in the late 1960s, hence the name.

This disease is rare, most often occurs in children under 5 years of age, Japanese and Korean descent Kawasaki Disease (for Parents). More precisely, it was so before.

Why doctors started talking about a possible connection between Kawasaki disease and coronavirus

In March-April 2020, Italy, UK explore possible COVID-19 link to child inflammatory disease was registered in Italy an unusually large number of children with symptoms of Kawasaki disease: 20 patients were admitted to the Bergamo hospital alone in a month. This is six times more than is usually recorded in a year.

Doctors were embarrassed that the outbreak of Kawasaki disease occurred in the same regions that were suffering from the coronavirus infection COVID-19 at the time. The connection between the two ailments was talked about, but with the neat wording "presumably". In addition, in most of the hospitalized children, PCR tests for coronavirus were negative.

However, soon outbreaks of COVID-19 and Kawasaki disease coincided in other regions - for example, in the UK Italy, UK explore possible COVID-19 link to child inflammatory disease, France Outbreak of Kawasaki disease in children during COVID-19 pandemic: a prospective observational study in Paris, France and the USA 15 Children Are Hospitalized With Mysterious Illness Possibly Tied to Covid-19. As in the Italian case, most of the children tested negative for coronavirus. But doctors continue to talk about the probable connection between these diseases. For example, it is identified in 2020 Health Alert # 13: Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19, compiled by the New York City Department of Health.

The same report indicates that the age of the affected children is from 2 to 15 years. That is, in contrast to the classic Kawasaki disease, adolescents were also affected.

Can coronavirus really cause Kawasaki disease?

Scientists have not yet figured out Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association, what exactly triggers Kawasaki disease.

Kawasaki Disease: Causes suggests that vascular inflammation occurs in genetically prone children. And some infections provoke it. For the role of triggers, scientists are considering bacteria, fungi, viruses - including the long-known coronaviruses that cause the common cold.

On this basis, theoretically, SARS ‑ CoV ‑ 2 may indeed be the factor that causes Kawasaki disease in children. However, doctors cannot yet confirm or deny this hypothesis.

Why is Kawasaki disease dangerous?

If the disease is diagnosed in time, then almost nothing Kawasaki Disease (for Parents). The vast majority of children feel better within a few days after the timely initiation of therapy.

But if you delay the visit to the doctors or do not go to them at all, serious complications are possible. Approximately 2-3% of Kawasaki Disease cases are fatal if left untreated. Another 25% of children have aneurysms (bulging of the wall) of the coronary arteries that supply the heart with blood. Blood clots can form in the vessels, the risk of heart attack, arrhythmias, and problems with heart valves increases.

Therefore, it is important to know how to recognize Kawasaki disease at an early stage in order to seek help in time. In this case, the risk of complications is reduced to 3-5%.

What are the symptoms of Kawasaki disease

Here are the characteristic early signs of Kawasaki Disease: Symptoms that appear in sick children:

High temperature - 38-40 ℃. It lasts five or more days, and sometimes it drags on for 3-4 weeks. With Kawasaki disease, the temperature is very difficult to bring down with conventional antipyretic drugs such as paracetamol or ibuprofen.
Rash. They can have different shapes, resembling a skin rash with chickenpox, measles, scarlet fever.
Redness and swelling of the skin on the fingers and toes. It may be painful for the child to touch or walk.
Reddened eyes - whites with burst capillaries.
Dry, chapped lips. The skin on them often flakes off, which makes it painful to eat or speak.
Enlarged lymph nodes in the neck. They are usually felt on one side.

After a week or two, the symptoms change: the temperature decreases, but headache, nausea, vomiting, joint pain, yellowing of the skin and whites of the eyes appear. But by this time you should already contact your pediatrician.

If the first signs manifest themselves acutely, and even more so if the child is less than six months old, do not wait for an appointment with a doctor. Call an ambulance.

To confirm the diagnosis and rule out measles and scarlet fever similar to Kawasaki, doctors will take urine and blood tests from the child, and also do an electrocardiogram.

How to treat Kawasaki disease

Children's vasculitis is treated only in a hospital. This is necessary so that doctors have time to respond to possible complications.

The therapy itself consists of Kawasaki's disease in an intravenous injection of a high dose of immunoglobulin (usually a single dose) and regular intake of aspirin, in the early days in large doses. This is one of those rare occasions when Kawasaki Disease: Treatment is prescribed aspirin to children under 16. The drug is necessary to bring down the temperature, alleviate the condition of the child and at the same time reduce the risk of blood clots in the coronary arteries.

In some cases, if classical treatment does not give the expected effect or the risk of complications is high, additional drugs are prescribed - corticosteroids or anticoagulants (drugs that thin the blood).