Kawasaki disease is a rare disease that causes vasculitis, or inflammation in the walls of the arteries throughout the body to include the heart’s coronary arteries. It primarily affects children who are younger than 5 years of age, though children as old as 13 years of age and as young as a newborn can be affected by the condition.
About Kawasaki Disease
Although symptoms usually subside after a couple of weeks, Kawasaki disease can make children very ill and the impacts on the heart and blood vessels can be significant. Coronary arteries are a critical part of a healthy heart because they supply the heart muscle with oxygen-rich blood. Kawasaki disease can weaken the wall in coronary arteries, causing a bulge where blood clots can form and potentially cut off blood flow to the heart muscle. Without enough oxygenated blood, the heart muscle can suffer damage.
Kawasaki disease can also cause inflammation and irritation in the heart muscle, the outer lining of the heart (pericardium), and other areas of the body, such as the skin, lymph nodes, and mucous membranes of the mouth, nose, and throat. A child with Kawasaki disease may also develop an irregular heartbeat or problems with their heart valves.
For most children, the effects of Kawasaki disease on the heart may only last five or six weeks and no permanent damage is caused. It may take more time for problems with the coronary arteries to go away. The cause of Kawasaki disease isn't known; however, if left untreated, Kawasaki disease can increase the risk for problems with the development of your child’s coronary arteries and other parts of the heart. With treatment, most children who have Kawasaki disease fully recover without any serious or lasting effects.
Symptoms of Kawasaki Disease
Your child may not experience symptoms of Kawasaki disease. For those children who do experience symptoms, the symptoms tend to last 10 to 14 days.
Symptoms of Kawasaki disease may include:
- A moderate to high fever for a minimum of five days
- Bloodshot or red eyes
- Peeling skin
- Red, dry, cracked lips
- Red, swollen palms and the soles of the feet
- Sensitivity to light
- Spotty, bright red rash
- Swollen lymph nodes
- Swollen, painful joints
Diagnosing Kawasaki Disease
A pediatrician or pediatric cardiologist may suspect Kawasaki disease based on your child’s medical history, symptoms, or a physical examination.
Tests performed when diagnosing Kawasaki disease may include:
- Chest X-Ray: A chest X-ray produces an image of the tissue and bones in the heart and lungs and helps your provider assess the shape, size, and structure of the heart and lungs as well as the aeration of or any congestion in the lungs.
- Echocardiogram: An echocardiogram uses ultrasound technology to create a moving image of the heart and its valves, allowing your provider to assess the structure and function of the heart. An echocardiogram also helps provide information about blood flow and how well the heart is pumping blood.
- Electrocardiogram (ECG or EKG): An electrocardiogram uses electrodes that are placed on the body to record the electrical activity taking place in the heart. An ECG/EKG test helps detect abnormal rhythms, such as cardiac arrhythmias, stress on the heart, and damage to the heart muscles.
- Lab Tests: Blood and urine tests can be used to evaluate how the kidneys and other organs are working as well as identify elevated platelet levels and high numbers of white blood cells.
Treating Kawasaki Disease
Kawasaki disease is treated with medication to mitigate damage and ease symptoms as the illness runs its course. Children with acute symptoms may be hospitalized for a few days if intravenous, or IV, medications are used.
Treatment options for Kawasaki disease may include the following medicines:
- Aspirin: Taken at high doses, aspirin helps lower the risk of blood clots and reduce inflammation. A low dose of aspirin may be taken for 6 to 8 weeks or longer to further protect the blood vessels and heart, especially if an aneurysm develops.
- Gamma Globulin or Corticosteroids: Given through an IV, gamma globulin helps the immune system fight the infection and may lessen the risk of damage to the heart and coronary arteries. Children who don’t respond to gamma globulin may be given corticosteroids instead.
Most children make a complete recovery after Kawasaki disease. Your child may need to continue seeing a pediatric cardiologist on a regular basis to check for problems with the heart or blood vessels. Ongoing care is important because heart problems can develop well after Kawasaki disease and your child may not experience any symptoms. A child who has had Kawasaki disease may also be at risk for early coronary artery disease later in life. Adopting heart-healthy habits and seeing a cardiologist as an adult can help prevent coronary artery disease.
Care Team Approach
The Texas Center for Pediatric and Congenital Heart Disease, a clinical partnership between Dell Children’s Medical Center and UT Health Austin, takes a multidisciplinary approach to your child’s care. This means your child and your family will benefit from the expertise of multiple specialists across a variety of disciplines. Your care team will include pediatric cardiologists, cardiothoracic surgeons, interventional cardiologists, critical care specialists, hospitalists, anesthesiologists, perfusionists, nurses, advanced practice providers, social workers, psychologists, child life specialists, dietitians, physical and occupational therapists, pharmacists, and more, who work together to provide unparalleled care for patients every step of the way. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve treatment outcomes. We are committed to communicating and coordinating your child’s care with referring physicians and other partners in the community to ensure that we are providing comprehensive, whole-person care.