Kawasaki disease is a syndrome that occurs most often in children under five years of age. This disease is a rare complex immune or infectious pathology, which is characterized by the presence of damage to the coronary arteries, and in addition, the manifestation of fever, conjunctivitis and other severe symptoms. Treatment of the disease is carried out in a clinical setting using medications.
What is this disease?
This disease was discovered in 1961. It was opened by the Japanese pediatrician Kawasaki, in whose honor she got her name. The doctor established pathologies of the heart, and in addition, coronary arteries, which were combined into a complex disease called "Kawasaki syndrome."
Against the background of this pathology, vasculitis of various coronary arteries and vessels occurs, among other things, aneurysm occurs. The main provoking factor is an increased level of T-lymphocytes in view of the presence of antigens to streptococci and staphylococci, however, today it is just a hypothesis that has not yet been confirmed by science.
Kawasaki disease in children is most often formed at an early age, from one year to five years. And thirty times more often it occurs in representatives of the Mongoloid race. According to statistics, eighty percent of patients are children under the age of three. In boys, this pathology is observed one and a half times more often than in girls.
In medical practice, there are cases of the onset of this disease among adults who are over thirty years old.
Causes of the disease
There is no specific explanation for the appearance of this pathology. But specialists have identified some patterns along with the cyclical occurrence of outbreaks of this disease, for example, seasonality, which may indicate the probable infectious nature of the disease.
In addition, examinations of sick people showed the presence of residues of unknown organisms in the blood that resemble one virus or another. Thus, the following parasites are considered to be the main pathogens: spirochaete, staphylococcus, parvoviruses, streptococcus, rickettsia, herpes, Epstein-Barr virus and retrovirus.
In accordance with another theory, the cause of the disease can lie in the immune system, and in addition, in hereditary factors - genes, because Asians more often than others suffer from this disease. The likely cause in this situation is the reaction of the body to an infection that triggers the mechanism of a huge complex of pathologies.
The clinical picture and symptoms
Typically, people who are sick with Kawasaki syndrome go through the following three stages:
- Acute febrile stage, which lasts from seven to ten days.
- Subacute stage, lasting from the second to the third week.
- The recovery period, which lasts from a month to several years.
The symptoms of Kawasaki disease are given below.
Initially, a person rises in temperature, as happens with a usual otolaryngological disease, then fever begins. In the absence of the necessary treatment, it can last up to two weeks. The longer this period lasts, the less likely it is to recover.
Further, problems begin with skin integuments from red spots to bloating, blisters and rashes. Densification of the skin on the sole of the feet, and in addition, the palms, is not excluded, while the mobility of the fingers is usually reduced. This symptomatology persists for about three weeks, then the skin begins to peel off.
Mucosal damage
In addition, damage to the oral mucosa and eyes occurs. In the first week, patients develop conjunctivitis in both eyes without any discharge. The mucous membrane of the mouth suffers from dryness and bleeding, for example, from the gums. In this case, the lips burst, crack, and the tongue becomes raspberry, tonsils, in turn, increase in size. In half the cases, an excessive increase in cervical lymph nodes in size is observed. From the coronary system, as well as the heart, the following symptoms appear:
- The development of myocarditis.
- The presence of heart failure, arrhythmias and tachycardia.
- The appearance of pain in the chest.
- Vascular aneurysm along with myocardial infarction and pericarditis.
- The development of mitral regurgitation.
In every third case of the development of this pathology, patients suffer from joint damage in the region of the knees, hands and ankle. Diarrhea is not ruled out along with abdominal pain, nausea and vomiting. In some cases, meningitis or urethritis occurs.
Pathology diagnostics
In medical practice, it is believed that the presence of an ongoing fever for five days or more is a sign of the likely presence of Kawasaki disease. In addition, at least four of the following five symptoms should be present:
- The presence of conjunctivitis on both eyeballs.
- The appearance of a rash in the groin, and in addition, on the feet and back.
- Inflammation of the mucous membranes of the mouth, lips and tongue.
- The presence of swelling of the hands and feet.
- Enlarged tonsils and lymph nodes.
In the event that the patient has coronary aneurysms, only three signs will be sufficient. Laboratory studies provide little information. But, as a rule, with the development of this disease, the patient rises in the level of leukocytes and platelets, blood biochemistry reports an excessive amount of immunoglobulin along with transaminase and seromucoid. In the urine, leukocyturia and proteinuria are observed.
As part of an additional diagnosis, an ECG of the heart is performed along with an x-ray of the thoracic region and an ultrasound scan. In addition, angiography of the coronary arteries is performed. In some situations, lumbar puncture is required. To differentiate Kawasaki’s disease (see the photo of patients in the article), other studies are also being carried out, it is important to be able to distinguish this pathology from measles, rubella, as well as scarlet fever and other ailments with similar symptoms.
Possible consequences and complications
Pathology against the background of a weakened immune system or improper treatment can lead to the development of myocarditis, arthritis, coronary aneurysm, gangrene, dropsy of the gallbladder, valvulitis, otitis media, aseptic meningitis and diarrhea.
What are the clinical guidelines for Kawasaki disease?
Methods of treating pathology
Radical methods of therapy today do not exist. This ailment cannot be treated with steroids or antibiotics. The only effective way to treat Kawasaki disease is through intravenous injection of acetylsalicylic acid and immunoglobulin simultaneously.
Thanks to immunoglobulin, pathologies occurring in the vessels along with inflammatory processes are stopped, thereby preventing the formation of aneurysms. Acetylsalicylic acid, in turn, reduces the risk of blood clots, having an anti-inflammatory effect. In addition, both drugs help reduce body temperature, eliminating fever and alleviating the patient's condition. In addition, anticoagulants can be prescribed to the patient in accordance with the doctor's testimony in order to prevent the occurrence of thrombosis. This is usually Warfarin and Clopidogrel.
Forecast: is it possible to get better?
How dangerous is Kawasaki disease in adults?
In the vast majority of situations, the prognosis is positive. The course of treatment usually lasts about three months. Mortality from Kawasaki disease is approximately three percent, this is mainly due to vascular thrombosis, as well as because of their subsequent rupture or heart attack.
About twenty percent of patients who have had this disease acquire changes in the coronary vessels, which in the future will cause atherosclerosis along with cardiac ischemia and an increased risk of myocardial infarction. Everyone who has suffered this syndrome must necessarily be under the supervision of a cardiologist throughout their lives and undergo an examination of the heart and blood vessels at least once every five years.
Recommendations
Since the causes of Kawasaki disease are still unknown to medicine, there are no specific recommendations in this regard. It is only required to seek timely treatment for any infectious diseases and, at the slightest alarming symptoms, seek medical help. Thus, it is important to carefully study this ailment in order to be able to timely identify it and go to the doctor. In the early stages, the disease is treated, and in the late stages, the formation of blood clots, along with the appearance of an aneurysm, can lead to death.