Kawasaki Disease

Kawasaki Disease (mucocutaneous lymph node syndrome, mucocutaneous node disease, infantile polyarteritis, and Kawasaki syndrome) first discovered in 1967 by Dr. Tomiasaku Kawasaki. Originally 50 Japanese children diagnosed with this disease. The disease attributed as the main cause heart disease among children, less than two years old and 85 percent of cases occurring in children younger than five years of age. According to American Heart Association, the illness is major cause of heart disease in children. About 4,000 children are diagnosed in the United States each year. The cause of Kawasaki disease is unknown, but epidemiologic investigations point in the direction of a microbial agent (microorganisms). The disease begins with a high and persistent fever (higher than 104 degrees Fahrenheit), lasting at least five days.

Acetaminophen or ibuprofen is not very affecting treating this disease. Further symptoms develop includes: Red eyes, swollen tongue with a white coating and big red bumps (strawberry tongue), red cracked lips, and swollen lymph nodes (The spleen and tonsils have large lymphoid organs which filter out blood cells from bacteria and viruses). Second phase of the disease may cause skin rashes (severity can cause peeling of the skin in the genital area, hands, and feet), diarrhea, vomiting and/ or abdominal pain. Treatment requires administering high doses of intravenous gamma globulin (Contain proteins or antibodies which increases a patient’s immunity against disease producing organism or fighting off infection), reduces the development of coronary artery aneurysms by at least five times the risk. Provided treatment begins within the first week to ten days of fever onset. In rare and selected cases treatment includes plasmapheresis treatment (therapeutic plasma exchange). During the process, removes circulating antibodies thought to be responsible for this disease.

Also, aspirin maybe administered in high doses by reducing the risk of heart problems, and treating fever. If a coronary artery aneurysm had developed, recommended continuation of aspirin administration at lower dosage, which helps prevent clotting. Usually, Kawasaki disease is treated within ten days of developing initial symptoms, and heart problems can be prevented. Within two days of treatment, symptoms dissipate. Less than two percent of Kawasakii patients will develop this disease more than once.

Kawasaki Disease has many common attributes related to children. In the United States, 19 out of every 100,000 children born develop this disease. It is most common among children of Japanese and Korean heritage. The disease is common in Japan. Approximately one percent affected children have a family history of Kawasaki disease. The disease is more likely in boys than girls. A greater number of cases have been reported during winter and spring season.

No tests available to detect Kawasaki disease. Physicians diagnose this disease by evaluating the child’s symptoms, and eliminating other conditions or diseases. Urine and blood tests can rule out scarlet fever, measles, Rocky Mountain spotted fever, juvenile rheumatoid arthritis and any allergic drug reaction. Early diagnose and treatment of Kawasaki disease can expect full recovery. However, about two percent of patients will die from complications related to coronary vasculitis. Advisable those that have recovered from Kawasaki disease have every one to two years an echocardiogram to screen for any future cardiac problems, especially any patient that had aneurysm detected.

Kawasaki Disease can causes vasculitis (Blood vessels consist of arteries that pass oxygenated blood to the tissues of the body, and veins return oxygen, depleted blood from the tissue to the lungs for oxygen. Vasculitis causes inflammation and damage to the wall of various blood vessels. Arrhythmia’s can develop which changes the normal pattern of the heartbeat.) In coronary arteries an aneurysm (When pressure of blood passing through part of weak blood vessel, forces the vessel to bulge outward. If the bulging stretches an artery to far, the vessel may burst and causing a person to bleed to death) can develop. Aneurysms can cause heart attacks (Occurs when the blood supply to a part of the heart is interrupted, causing death and scaring of heart tissue.) in young children. Vasculitis is common in 20 to 40 percent of children with Kawasaki disease. A coronary angiograhy procedure maybe recommended, where a dye is injected in the arteries that supply the heart, looking for evidence of an aneurysm.

The Kawasaki Disease Program at Children’s Hospital Boston provides care for patients with this disease, during acute phase and long – term follow-up examinations. During the year, physicians and nurses at Children Hospital Boston treat approximately 50 to 65 new patients and suspected children having Kawasaki disease. Also, more than 1,000 children and young adults are enrolled in a long term Kawasaki Disease Program. Also, this program offers national and internationally information and resources for parents and physicians.

Physicians have been studying Kawasaki disease. In the November 15, 2005, issue of the ‘Journal of Infectious Disease,’ a study points in the direction that a single respiratory viral cause of Kawasaki disease, entering through the respiratory route, infecting bronchi and leading to formation of inclusion bodies in the bronchi of children with the disease. The eighth International Kawasaki Disease symposium was held February 17 – 20, 2005 in the Omni San Diego Hotel, California. The symposium sponsored by the American Heart Association councils.

The conference provided information for recognizable therapies, long – term care, identifying areas of progress, and modification for clinical case definition. Reported in May 2001, Dr. Masaru Terai of the Chiba University School of Medicine in Japan studied a treatment for Kawasaki disease. The study, published in Journal the American Heart Association, looked at seven children aged six to 19 years old. Combining a series of ten minutes exercises and administering heparin, a drug promotes the development of new blood vessels. The conclusion of the study determined the combination of heparin and physical stress is required, for improvement in collateral circulation.

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