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Kawasaki disease An acute condition affecting
children that can weaken the CORONARY ARTERIES
and other cardiovascular structures, resulting in
HEART ATTACK, ANEURYSM, or permanent damage.
Kawasaki disease, also called mucocutaneous
LYMPH NODEsyndrome, comes on suddenly with
RASH, FEVER, CONJUNCTIVITIS, and swollen lymph
nodes (LYMPHADENOPATHY). The characteristic symp-
tom that raises suspicion the condition is more
than a typical viral INFECTIONis the bright red color
of the lips and mucous membranes in the MOUTH.
After about five days the palms of the hands and
soles of the feet also become bright red. The child
appears, and is, very ill. The acute phase of the
disease runs about three weeks. The diagnostic
path is primarily clinical; there are no definitive
tests for Kawasaki disease.
Treatment during the acute phase includes
efforts to keep the child comfortable as well as
administering high-DOSEaspirin. Aspirin, not usu-
ally given to children who have fevers because of
the risk for REYE’S SYNDROME, is the treatment of
choice for Kawasaki disease because it not only
reduces FEVER but also reduces cardiovascular
INFLAMMATIONand has antiplatelet action that helps
prevent blood clots from forming. These effects
lower the likelihood of cardiovascular damage or
crisis. Intravenous IMMUNOGLOBULIN, which delivers
generalized antibodies that aid the body’s IMMUNE

RESPONSE, given early in the course of the disease

seems to mitigate symptoms in some children.

Sometimes cardiovascular symptoms manifest

during the disease’s acute phase, though typically

it is months to years later that problems become

apparent. Doctors recommend cardiovascular

assessment, including ELECTROCARDIOGRAM (ECG)

and ECHOCARDIOGRAM, for children at the time of

diagnosis. Detected cardiovascular changes require

regular followup, with treatment as necessary. The

most serious long-term consequences of Kawasaki

disease are aneurysms of the coronary arteries

that cause heart attack. In some children, inflam-

mation attacks the heart valves, resulting in VA LV U-

LAR HEART DISEASEthat requires ongoing medical

attention and sometimes heart valve replacement

in adulthood.

Doctors believe an infectious agent, such as a

VIRUS, likely causes Kawasaki disease though as yet

researchers have been unable to isolate it. Though

occasionally there appear to be clusters of

Kawasaki disease, the condition does not appear

to be contagious through contact among family

members and close contacts. Children under five

years of age are most likely to develop Kawasaki

disease. Children who have had Kawasaki disease

rarely get it again.

See also ANTIBODY; SCARLET FEVER; TOXIC SHOCK

SYNDROME.

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