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 lesions of the coronary arteries, and in addition, the manifestation of fever, conjunctivitis and other severe symptoms. The 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, after whom she got her name. The doctor established pathologies of the heart, and in addition, of the coronary arteries, which were combined into a complex disease called "Kawasaki syndrome".
Against the background of this pathology, vasculitic lesions of various coronary arteries and vessels occur, among other things, aneurysms occur. The main provoking factor isan increased level of T-lymphocytes due to the presence of antigens to streptococci and staphylococci, however, today this is just a hypothesis that has not yet been confirmed by science.
Kawasaki disease in children most often develops at an early age, between one and five years of age. Moreover, it occurs thirty times more often 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 this disease among adults who are over thirty years old.
Causes of disease
There is no specific explanation for the appearance of this pathology. But experts have identified some patterns along with the cyclical nature of outbreaks of this disease, such as seasonality, which may indicate the likely infectious nature of the disease.
In addition, examinations of sick people showed the presence of remnants of unknown organisms in the blood, which resemble certain viruses. Thus, the following parasites are considered the main pathogens: spirochetes, staphylococcus, parvoviruses, streptococcus, rickettsia, herpes, Epstein-Barr virus and retrovirus.
According to another theory, the cause of the disease may lie in the immune system, and in addition, in hereditary factors - genes, because Asians suffer from this disease more often than others. The likely reason for thissituations consider the body's reaction to an infection, triggering the mechanism of a huge complex of pathologies.
Clinical presentation and symptoms
Typically, people who have Kawasaki syndrome go through the following three stages:
- Acute febrile stage that lasts seven to ten days.
- Subacute stage lasting from the second to the third week.
- A recovery period that lasts from a month to several years.
Kawasaki disease symptoms are listed below.
First, a person has a fever, as is the case with a common otolaryngological disease, then a fever begins. In the absence of the necessary treatment, it can last up to two weeks. The longer this period lasts, the less chance there is for recovery.
Next, skin problems start from red spots to swelling of the skin, blisters and rashes. Thickening of the skin on the soles of the feet, and in addition, on the palms, is not excluded, while, as a rule, the mobility of the fingers decreases. This symptomatology persists for about three weeks, then the skin begins to peel off.
Mucosal lesions
In addition, there is damage to the oral mucosa and eyes. 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. At the same time, the lips burst, crack, and the tongue becomes crimson, the tonsils, in turn,increase in size. In half of the cases, an excessive increase in the size of the cervical lymph nodes is observed. From the side of the coronary system, as well as the heart, the following symptoms appear:
- Development of myocarditis.
- Presence of heart failure, arrhythmia and tachycardia.
- The appearance of pain in the chest.
- Vascular aneurysms along with myocardial infarction and pericarditis.
- Development of mitral insufficiency.
In every third case of the development of this pathology, patients experience damage to the joints in the area of the knees, hands and ankles. Diarrhea is not ruled out along with abdominal pain, nausea and vomiting. In some cases, meningitis or urethritis occurs.
Diagnosis of pathology
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 must be present:
- Presence of conjunctivitis on both eyeballs.
- Appearance of a rash in the groin, and in addition, on the feet and back.
- Inflammation of the oral mucosa, lips and tongue.
- Swelling of the hands and feet.
- Enlarged tonsils and lymph nodes.
In the event that the patient has an aneurysm of the coronary vessels, only three signs will be enough. Laboratory studies provide little information. But, as a rule, with the development of this disease in a patientthe level of leukocytes and platelets rises, blood biochemistry reports an excessive amount of immunoglobulin along with transaminase and seromucoid. At the same time, leukocyturia and proteinuria are observed in the urine.
As part of additional diagnostics, an ECG of the heart is performed along with an x-ray of the thoracic region and ultrasound. In addition, an angiography of the coronary arteries is performed. In some situations, a lumbar puncture is required. To differentiate Kawasaki disease (photos of patients are in the article), other studies are also carried out, it is important to be able to distinguish this pathology from measles, rubella, as well as from scarlet fever and other ailments with similar symptoms.
Possible consequences and complications
Pathology due to a weakened immune system or improper treatment can lead to the development of myocarditis, arthritis, coronary aneurysm, gangrene, hydrops 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 do not exist today. This disease is not treatable with steroids or antibiotics. The only effective treatment for Kawasaki disease is intravenous injections of acetylsalicylic acid and immunoglobulin at the same time.
Thanks to immunoglobulin, pathologies occurring in the vessels along with inflammatory processes are stopped, which thereby prevents the formation of aneurysms. Acetylsalicylic acid, in turn, reducesthe risk of blood clots, having an anti-inflammatory effect. In addition, both drugs help to reduce body temperature, eliminating fever and alleviating the patient's condition. Additionally, the patient may be prescribed anticoagulants in accordance with the doctor's indications in order to prevent the occurrence of thrombosis. These are usually Warfarin and Clopidogrel.
Forecast: can I get better?
How dangerous is Kawasaki disease in adults?
In the vast majority of situations, the forecast is positive. The course of treatment usually lasts about three months. Mortality from Kawasaki disease is approximately three percent, mainly due to vascular thrombosis, as well as due to 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 is the cause of atherosclerosis along with cardiac ischemia and an increased risk of myocardial infarction. All who have suffered this syndrome must 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 treatment for any infectious diseases in a timely manner and, at the slightest alarming symptoms, seek medical help. Thus, it is important to carefully study thisailment in order to be able to identify it in time and go to the doctor. In the early stages, the disease is treated, and in the later stages, the formation of blood clots along with the appearance of an aneurysm can be fatal.
