Kawasaki Disease - From Fever to Heart Health

Kawasaki Disease: Early Symptoms and When to Seek Help

Kawasaki disease is a rare illness that causes widespread inflammation of blood vessels, especially targeting the heart and coronary arteries. It primarily affects children and is a leading cause of acquired heart disease in this age group. Early diagnosis and treatment are essential to reduce the risk of serious heart complications.

What are the key symptoms of Kawasaki disease?

It exhibits symptoms like swollen lymph nodes, prolonged fever, rashes, red eyes and changes in the mouth. Let us discuss the symptoms in detail:

• Prolonged Fever: A fever of 102.2℉ (39℃) or higher, which lasts for more than five days, is a common symptom of Kawasaki disease.
• Rash: A widespread rash, often on the extremities or trunk, may develop, causing intense itching and irritation.
• Swollen Lymph Nodes: Enlarged lymph nodes, particularly in the neck region, are common in individuals suffering from Kawasaki disease.
• Red Eyes: Individuals suffering from this condition experience symptoms such as red, bloodshot eyes without discharge.
• Changes in Mouth and Lips: The lip may become red, cracked and dry, and the tongue may get a strawberry-like appearance.
• Swelling and Redness of Hands and Feet: Hands and feet may become swollen and red, potentially with peeling skin in the later stages of the disease.
• Joint Pain and Irritability: Many children experience joint pain and increased irritability with the progression of the illness.
• Gastrointestinal Issues: Some patients experience gastrointestinal issues, like vomiting, diarrhoea, and abdominal cramps.
• Heart-related Complications: In some cases, prolonged suffering from Kawasaki disease can lead to serious heart-related complications, like aneurysms.
   

What Causes Kawasaki Disease?

The exact cause of Kawasaki disease is still unknown and is under investigation. However, experts believe it may occur due to an abnormal immune system response to any particular infection or other environmental factor in genetically predisposed individuals. Autoimmune conditions can lead to the development of Kawasaki disease in children.

Though no specific infectious agent has been identified, some research suggests that bacterial or viral infections can cause this condition in children. Additionally, other studies suggest that prolonged exposure to environmental factors, such as pollutants or toxins, can increase the risk.

How is Kawasaki Disease Transmitted?

Kawasaki disease does not transmit from person to person. It is an autoimmune condition where the immune system mistakenly attacks the healthy blood vessels, particularly in children. Though it is not directly inherited like other genetic conditions, a strong family history increases the child's risk.

This suggests that genetic predisposition may play a crucial role in the development of this disease. Studies show that mutations in the ITPKC gene are associated with an increased risk of developing the disease. This particular cluster of genes provides instructions for producing enzymes that regulate T-cell activities.

How to Diagnose Kawasaki Disease?

Doctors physically examine symptoms, such as high fever, conjunctivitis, rash and enlarged lymph nodes. However, for a proper examination and confirmation of the conditions, healthcare providers run some diagnostic tests to diagnose Kawasaki disease. These include:

• Blood Tests: A rapid blood test assesses inflammation and blood cell counts and rules out other possible infections. Specific blood tests, such as erythrocyte sedimentation rate (ESR), complete blood count (CBC), and C-reactive protein, can confirm the positive signs of inflammation inside the body.
• Urine Tests: Urine tests can identify certain proteins, biomarkers, and white blood cells (pyuria) within the urine sample. Proteins like filamin C and meprin A may be present in the urine samples of individuals with Kawasaki disease. These suggest potential damage to blood vessels or cardiac muscle cells.
• Electrocardiogram (ECG): Kawasaki disease causes irregular heartbeats, so an ECG can help healthcare providers detect any of these issues. It also helps to identify signs of myocarditis, a common complication of Kawasaki disease, by detecting specific changes in the heart's electrical activity.   
• Echocardiogram: An echocardiogram detects aneurysms in the coronary arteries, a common complication of Kawasaki disease. Signs of any weak and bulging spots in the coronary arteries may be a sign of severe Kawasaki disease. EEG can detect other complications, such as pericarditis, pericardial effusion, and valvulitis.
   

How to Treat Kawasaki Disease?

Let us explore the treatment approaches for Kawasaki disease to lessen inflammation and heart complications. Here are the two types of treatment methods for Kawasaki disease:

• Intravenous Immunoglobulin: IVIG is a concentrated preparation of antibodies from a healthy donor’s blood. It reduces inflammation in the blood vessels, especially coronary arteries.
• High-dose Aspirin: Aspirin controls fever and inflammation, which also prevents blood clots. Doctors administer these in high doses in the initial phase to control the inflammation.
   

Some children may need to take aspirin or other medications for a certain period to manage potential heart illnesses. Regular checkups are crucial to monitor the heart and coronary arteries for any abnormalities.