Kawasaki Disease

What is Kawasaki disease?

Kawasaki disease causes inflammation or swelling of the blood vessels. It affects the coronary arteries, which carry blood and oxygen to the the heart muscles.

Kawasaki disease usually causes these symptoms:

  • 5 or more days of fever
  • red or bloodshot eyes
  • red lips, mouth, or tongue
  • puffy or red hands and feet
  • rash
  • swollen glands in the neck

Kawasaki disease is a rare illness. It usually affects children under the age of 5. But older children can also be affected.

We do not know what causes Kawasaki disease. There is no specific test to diagnose it. We also do not know why some children get the disease and others do not.

Other children cannot catch Kawasaki disease

Kawasaki disease is not contagious. This means that it does not spread from child to child.

It is very rare for 2 children in the same family to get Kawasaki disease.

Kawasaki Disease
Get Adobe Flash player
-UNIQUE1-IHD_kawasaki_MED_ILL_EN-UNIQUE2-
An inflammatory disease that, among other things, affects blood vessels in the body, particularly the coronary arteries.

Kawasaki disease can damage the heart

Kawasaki disease causes inflammation or swelling of the blood vessels. It affects the coronary arteries, which carry blood and oxygen to the heart muscle. The heart itself needs blood and oxygen in order to work well.

If not treated, about 1 out of every 5 children with Kawasaki disease will have some damage to the coronary arteries. In most children, this damage is minor. It does not last long. In some children, though, the damage can last into adulthood. In these children, the walls of the coronary arteries can become weak and form aneurysms.

Aneurysms happen when the wall of the coronary arteries balloons outwards. Aneurysms are dangerous. They can cause problems with blood flow to the heart muscle. Medicine can help prevent this damage.

Kawasaki disease is treated with medicine

A child with Kawasaki disease will need to stay in the hospital for a few days. We will give your child medicine to try to prevent damage to the coronary arteries. The medicines we use are called intravenous immune globulin (IVIG) and ASA (acetylsalicylic acid or Aspirin).

After a child is treated, the fever usually goes away for good. Sometimes a child will need a second treatment with IVIG or other medicines.

IVIG

IVIG is given through an intravenous (IV) needle in your child's vein. It can reduce the inflammation (redness and swelling) in the body. In turn, this can:

  • reduce the fever and redness caused by the disease
  • help protect against heart problems

IVIG contains antibodies from donated blood. It is screened for viruses and bacteria before it is used as a treatment. If you are concerned about this, talk to your doctor.

ASA

ASA is given by mouth 4 times a day at first. In these high doses, ASA also helps reduce inflammation in the body.

We will do a test to look for changes in the coronary arteries

Your child will have a test called an echocardiogram. This is a test that uses sound waves to take a picture of your child's heart. It lets us see if there are any changes in the coronary arteries. If they are affected, they may look widened or swollen.

Several different doctors look after children with Kawasaki disease

Kawasaki disease may be diagnosed by a paediatrician, an emergency doctor, or a family doctor.

Two types of paediatric specialists also help care for children with Kawasaki disease. These are rheumatologists and cardiologists.

  • The rheumatologist is an inflammation specialist. He or she will help help diagnose Kawasaki disease and decide on treatments while your child is in the hospital.
  • The cardiologist is a heart specialist. He or she will look at the echocardiogram. He or she will see your child after going home from hospital.

Most children with Kawasaki disease recover completely

Most children go home from hospital after a few days. Usually the only medicine your child will keep taking at home is ASA, once a day. This lower dose of ASA will protect the heart until your child has another echocardiogram. This will happen about 6 weeks after the diagnosis.

After this test, your child will likely be able to stop taking ASA. A year later, your child will have another echocardiogram. This is to make sure the disease has gone away completely.

Most children with Kawasaki disease recover completely. Sometimes the cardiologist will want to do more heart tests or prescribe other medicines.

Your child should continue to exercise and make healthy food choices

At this time, we do not know if children with Kawasaki disease and normal echocardiograms are more likely to develop heart problems when they are adults. All children should follow a healthy lifestyle, but it may be even more important in children who have had Kawasaki disease. A healthy lifestyle includes:

  • making healthy food choices
  • taking part in activities and exercise that your child enjoys
  • avoiding known risk factors for heart disease, such as smoking

Please ask your family doctor or paediatrician for information about healthy active living.

Your child should wait at least 9 months until the next vaccines

After treatment with IVIG, your child should wait to have the next scheduled immunizations (vaccines). The vaccines will not hurt your child, but they may not work as well. Your child should wait at least 9 months after treatment with IVIG.

Your child can take the flu vaccine as usual.

Your child should avoid getting chickenpox

If your child is taking ASA​, he or she should try not to get chickenpox. The combination of ASA and chickenpox is dangerous. It has been linked with an illness called Reye's syndrome. Tell your child's teachers about this. Ask them to let you know if there is chickenpox in the classroom.

While your child is taking ASA, if your child is in contact with chickenpox or gets chickenpox, tell your child's doctor.

Key points

  • Kawasaki disease causes swelling of the blood vessels. It can affect the heart.
  • Your child will be admitted to hospital for treatment. Treatment usually involves 2 medicines: intravenous immune globulin (IVIG)​ and ASA (Aspirin).
  • Most children with Kawasaki disease recover completely. We do not know if they are more likely to get heart disease in the future.

Elizabeth Stringer, MD, FRCPC

Rae SM Yeung, MD, PhD, FRCPC

12/4/2008




Notes: