How is Kawasaki disease treated?

Written by Yao Li Qin
Pediatrics
Updated on October 23, 2024
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Kawasaki disease, also known as mucocutaneous lymph node syndrome, can cause damage to the coronary arteries in untreated children, so it is crucial to treat the disease promptly once diagnosed. This disease generally occurs sporadically or in small outbreaks and can occur in any season, predominantly affecting infants and young children. The main treatment for Kawasaki disease is aspirin, which not only reduces fever but also helps reduce coronary artery lesions. Additionally, intravenous immunoglobulin is administered; however, the use of corticosteroids in Kawasaki disease is still somewhat controversial. Other treatments mainly include antiplatelet aggregation agents such as dipyridamole, and symptomatic supportive care for the child, including fluid supplementation, heart protection, control of heart failure, and correction of arrhythmias. For severe coronary artery lesions, coronary artery bypass surgery may be required. (Please use medication under the guidance of a professional physician.)

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Written by Li Jiao Yan
Neonatology
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How many days does it take to be discharged from the hospital for Kawasaki disease?

Kawasaki disease is a disease with unclear pathogenesis and etiology. A major pathological change is systemic vasculitis, which commonly affects the coronary arteries. Typically, it presents with fever lasting from seven to fourteen days or longer, and antibiotics are ineffective in treatment. During the first through sixth weeks of the illness, complications such as pericarditis, myocarditis, endocarditis, and arrhythmias may occur. Coronary artery damage often occurs between the second and fourth weeks of the illness, and proactive and effective treatment of Kawasaki disease can prevent coronary complications. The acute phase generally involves symptomatic supportive care, prevention of platelet aggregation, fever reduction, and prevention of coronary artery damage. Treatment with intravenous immunoglobulin is recommended within the first ten days of onset. If the treatment is not effective, other special medications like steroids may be used, and the treatment duration is generally between two to four weeks. Thus, the pathogenesis of Kawasaki disease is uncertain, and its pathological process is prolonged. The specific timing of discharge depends on the child's condition. If the fever is controlled and no significant coronary artery damage is evident, and the condition is stable, then discharge is possible. However, post-discharge, follow-up should be conducted based on the child's specific condition. Therefore, the duration of hospitalization for Kawasaki disease is not fixed and depends on the child's condition and treatment response.

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Written by Li Jiao Yan
Neonatology
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Can Kawasaki disease be cured?

Kawasaki disease, also known as mucocutaneous lymph node syndrome, has an unclear pathogenesis. The primary pathological change is systemic vasculitis. It commonly affects infants and young children, with 80% of cases occurring in children under five years of age. Kawasaki disease is a self-limiting condition, and most cases have a good prognosis. However, there is a 1% to 2% chance of recurrence. If not effectively treated, 15% to 25% of cases may develop coronary artery aneurysms. These aneurysms often resolve on their own within two years after the disease, but often leave behind abnormalities such as thickening of the vessel wall and decreased elasticity. Larger aneurysms may not completely resolve and can lead to thrombosis or narrowing of the vessel. Kawasaki disease is also one of the causes of acquired heart disease in children. Therefore, Kawasaki disease should be treated promptly and effectively to prevent severe complications.

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Written by Li Jiao Yan
Neonatology
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Does Kawasaki disease cause vomiting?

Kawasaki disease is a disease with no clear etiology, commonly seen in infants and toddlers, with eighty percent of cases occurring in children under five years old. Its main pathological change is systemic vasculitis. The main symptoms include fever, congested and cracked lips, diffuse congestion of the oral mucosa, swollen tongue papillae, and strawberry tongue. Other symptoms may include swelling of the hands and feet, polymorphous erythema, and enlarged lymph nodes. There could be subsequent cardiac complications, primarily affecting the coronary arteries. Kawasaki disease may cause vomiting due to the diffuse congestion in the oral cavity, and the pharynx might also be congested. When children experience significant congestion, their laryngeal reflex might be sensitive, possibly leading to vomiting. Furthermore, children with Kawasaki disease might develop secondary infections from other bacteria and viruses, which could also lead to symptoms like vomiting. Therefore, the manifestations of Kawasaki disease can vary, and if significant vomiting occurs, it should be investigated to determine the cause.

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Written by Yan Xin Liang
Pediatrics
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Is Kawasaki disease characterized by eye discharge?

Kawasaki disease is an autoimmune vasculitis that can affect blood vessels throughout the body and various organs, but the most severe impact is typically on the coronary arteries, which can lead to dilation of the coronary arteries or the possibility of forming coronary artery aneurysms. The disease can cause conjunctival congestion, but this is a manifestation of aseptic conjunctivitis, meaning it does not cause, nor does it result in, purulent secretions, in other words, it does not cause eye discharge. Therefore, if a patient with Kawasaki disease has purulent eye discharge, it is possible that they have a concurrent bacterial conjunctivitis. Thus, generally, eyes affected by Kawasaki disease do not have eye discharge but may appear dry and red.

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Written by Li Jiao Yan
Neonatology
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Is Kawasaki disease serious?

Kawasaki disease is an etiologically unclear disease with a not well-understood pathogenesis. The principal pathological change involves inflammatory changes in the systemic blood vessels, which can affect the coronary arteries and lead to coronary artery aneurysms and dilation. Kawasaki disease is self-limiting, and most cases resolve well, with recurrences seen in 1-2% of cases. For patients without coronary artery lesions, comprehensive examinations are required 1 month, 3 months, 6 months, and 1-2 years after discharge, including physical examinations, electrocardiograms, and echocardiograms, mainly to assess the heart's condition. If not effectively treated, 15-20% may develop coronary artery aneurysms; such cases need semi-annual or annual medical check-ups. Coronary artery aneurysms often self-resolve within two years post-diagnosis, typically leaving functional abnormalities such as thickening of the vessel wall and reduced elasticity. Major artery aneurysms often do not disappear completely and can lead to thrombosis or narrowing of the vessel lumen. Kawasaki disease is one of the common causes of acquired heart disease in children; therefore, if Kawasaki disease is accompanied by severe coronary damage, it may heal well but could lead to heart disease. If it is not a severe case of Kawasaki disease, timely treatment can still result in a good recovery.