Kawasaki Disease/Syndrome

Kawasaki Disease which at times is referred to as Kawasaki Syndrome is a condition in which the walls of both small and medium arteries in the entire body including the coronary arteries. This disease mainly affects infants and young children. It is the leading cause of heart disease in children. Eighty percent of the those with this disease are patients under five years old however, older children and teenagers can also get this disease but it is rare. This disease afflicts boys more than girls, most times it is diagnosed in the seasons of winter and early spring. Kawasaki is a non-contagious disease.

Kawasaki has also been called mucocutaneous lymph node syndrome due to the fact it also affects the lymph nodes, skin and mucus membranes inside the mouth, nose and throat.

Brief history of Kawasaki

A Japanese pediatrician named Tomisaku Kawasaki, was the first to describe this illness and 1967 in medical literature, and following this the disease was named after him. This disease is more common among those children who are of Asian and Pacific heritage however, it does affect all racial and ethnic groups. The cause of this disease is unknown. The first cases outside of Japan were reported in Hawaii in 1976.

In the United States population founded and hospitalization studies have given estimates of occurrences of this disease span from nine to nineteen for each 100,000 children, younger than five years old. Kawasaki disease had hospitalization rates of exactly 4,248 and among that number 77% of were children under the age of five. In 2006, Kawasaki disease had hospitalized 5,523 patients and that percentage of children remained at 77%.

Early symptoms for disease:

A fever higher than 101.3 F and endures five or more days (one or two weeks)

A rash in the main body area(trunk) and genital area where it is usually worse.

Red blood shot eyes (conjunctivitis) in which do not drain or crust.

Red, dry, cracked lips and an extremely red swollen tongue (strawberry tongue - shiny bright red spots).

Hands and feet are swollen and redness on palms and soles of the feet.

Swollen lymph nodes in neck and possibly other areas.

Irritability.

Second Stage of disease:

Skin peels on the hands and feet, particularly the tips of fingers and toes usually in large sheets.

Joint Pain

Diarrhea

Vomiting

Abdominal pain

Third Phase of disease:

Signs and symptoms start to go away at a slow rate unless complications set in. This disease can endure for up to eight weeks before normal energy levels are seen.

Visit your practitioner if the following occurs:

Redness appears in both eyes.

Very red swollen tongue.

Palms of hands or soles of feet are red.

Skin starts peeling.

A rash appears.

Swollen lymph nodes.

Seeking treatment within ten days of the start of disease could possibly significantly decrease the chances for lasting damage.

If no treatment is sought, around 25% of children develop heart disease occurring in the coronary arteries. Therefore, seeking immediate treatment is vital. Practitioners are continually studying the long term results of children who do not have any coronary involvement.

There are theories surrounding the cause of the disease even though none have been proven to date. One theory is the disease is associated to bacteria, viruses, or other environmental factors. Certain genes could increase the risk in children for the disease.

Risk Factors:

Currently only three things are known to increase a child's risk factor for the disease:

Children under five years old are at a greater risk.

Boys have a slightly higher chance for the disease.

Children of Asian descent do have higher rates of Kawasaki disease.

Known complications from the disease:

As previously stated Kawasaki disease is the primary cause of heart disease in children. Estimates indicate one in five children with the disease develop heart problems. However, only a small percentage of children have permanent damage.

The heart complications include

Inflammation of heart muscles (mayocarditis)

Heart valve problems (mitral regurgitation)

Abnormal heart rhythm (dysrhythmia)

Inflammation of blood vessels (vasculitis). Most often the coronary arteries which supply blood to the heart.

Any of the above complications can damage the child's heart. Inflammation of the coronary arteries can result in an aneurysm. Aneurysms add to the risk of developing blood clots and artery blockage. This in end result can cause a heart attack or internal bleeding which can be life threatening.

Please note this disease can be fatal even with treatment however, treatment decreases the risk for fatal events.

Testing and diagnosis

There is no designed specific test for this disease. Diagnoses is mainly found on process of elimination of the diseases in which produce similar signs and symptoms:

Scarlet Fever

Juvenile Rheumatoid Arthritis

Steven-Johnson Syndrome

Toxic Shock Syndrome

Measles

Tick-borne illnesses like Rocky Mountain spotted fever

Tests

These tests may also be done to rule out other conditions or diseases.

Urine test

Blood tests (presence of anemia and inflammation is a sign of the disease)

Electrocardiogram

Echogram

Conventional treatments:

Gamma globulin: A mixture consisting of the immune protein (gamma globulin) administered intravenously. It could lower the risk for the occurrence of coronary artery problems.

Aspirin: Given in high doses it could aide in inflammation. It also helps to lessen joint inflammation and pain along with reducing fever. Kawasaki disease is the exception for the rule of no aspirin for children.

Please note that due to risk of serious complications with this disease, the child most often will receive beginning treatments in the hospital.

Treatment following initial treatment:

Upon reduction of fever low dose aspirin may still be prescribe for six to eight weeks dependent upon if child develops a coronary artery aneurysm. Aspirin helps to prevent clotting.

If child develops the flu or chicken pox during this time, aspirin must be stopped immediately. Aspirin has been associated to Reye's Syndrome.

If the child should develop any signs of heart problems further tests and monitoring of heart will be ordered. If further complications set in with the heart the child will be referred to a pediatric cardiologist who will prescribe their own treatment.

Alternative Treatments

By no means is alternative treatments to replace conventional ones. Check with your child's practitioner first before starting any alternative treatments.

In Ayurveda medicine treatment for Kawasaki is pointed at treating the symptoms and to decrease any complications. Some treatments may include:

Chandrakala-Ras which is used as a fever treatment.

Skin rashes which include redness, swelling and peeling of skin include Manjishtha, Haridra and Bhrungraj.

Topical ointments for rash to be applied on the skin contain ingredients such as Mandukparni and Harida.

Enlargement of lymph nodes are treated with medications that include Triphala-Guggulu and Kachnaar-Guggulu.

Complications which are long term such as aneurysm have been treated with medications like Panch-Tikta-Ghrut-Guggulu for the prevention.

It is very essential to remember that most patients with Kawasaki disease do recover totally, complications of this disease which leads to death is present in one to two percent of cases and 95% of cessation of life occurs within six months of the infection.

Seeing a qualified and experienced practitioner is vital for this disease. Hospital care and conventional medicine at the beginning and regular stages along with long term follow up care by a physician is very important. The Ayurvedic medicines are only mean to be used as an additional treatment, they are in no way to be used solely for the treatment of this disease.

For more information on this disease you visit Kawasaki Disease Foundation.

For Support

Kawasaki Support Group online at Medindia Health Network

Kawasaki Families Network

46-111 Nahewai Pl.
Kaneohe, HI 97644
Voice: 808-525-8027
E-mail: vicki.machado@verizon.net

Sources:

Right Health

Medicine Net

KD Foundation

Mayo Clinic

Kawasaki Syndrome Ayurvedic