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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What should not be eaten with Kawasaki disease?

One of the main pathological changes in Kawasaki disease is systemic vasculitis. Clinically, common symptoms include fever, high fever, recurrent fever, conjunctival congestion, significant oral mucosal congestion, strawberry tongue, enlargement of neck lymph nodes, and peeling of the hands and feet. In cases of Kawasaki disease, oral mucosal congestion is a common complication, hence during the period of Kawasaki disease, it is advised not to consume irritating, spicy, or hot foods. These might exacerbate the child's discomfort, affect their nutrient absorption, and potentially worsen the condition. Therefore, during the illness, it is preferable to focus on bland, easy-to-digest foods.

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Written by Li Jiao Yan
Neonatology
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What is Kawasaki disease?

Kawasaki disease is a disease possibly related to viruses. Currently, the exact cause of Kawasaki disease is unclear, and the mechanism of its onset is also not well understood. It is characterized primarily by systemic vasculitis and is an acute febrile exanthematous disease. Clinically, it presents with symptoms such as rash, fever, conjunctival congestion, cracked lips, oral mucosal congestion, enlarged cervical lymph nodes, and peeling of the skin on the extremities. The cause of Kawasaki disease is unclear, but various viral infections observed clinically could potentially exacerbate the progression of Kawasaki disease. It mainly affects the coronary arteries, so there is a certain link between Kawasaki disease and viruses. However, it is not necessarily the direct cause of Kawasaki disease but could worsen or be a concomitant disease.

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Written by Shi Ji Peng
Pediatrics
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Kawasaki Disease Aspirin Side Effects

Aspirin is necessary for Kawasaki disease. Considering the pros and cons, aspirin must be used in cases of Kawasaki disease, initially in high doses. However, aspirin indeed has side effects. Some say aspirin is contraindicated for children, as its consumption can lead to Reye's Syndrome. This syndrome involves widespread mitochondrial damage following the intake of salicylate drugs during viral infection recovery, posing risks to the liver and brain. Without timely treatment, it could likely lead to liver and kidney failure, brain damage, or even death. Thus, aside from specific diseases, the use of aspirin is strictly prohibited. These specific diseases include Kawasaki disease, rheumatoid arthritis, etc. Therefore, the use of aspirin in Kawasaki disease is necessary, but it can indeed lead to some side effects.

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Written by Yan Xin Liang
Pediatrics
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Kawasaki disease sequelae

Kawasaki disease is an autoimmune vasculitis, and since it is vasculitis, it can originate from blood vessels in various parts, including the heart, liver, kidneys, brain, and more. However, it mainly arises from the coronary arteries of the heart. If Kawasaki disease is not effectively treated, some patients can develop coronary artery dilation and even coronary artery aneurysms. Once a coronary artery aneurysm occurs, its complication includes the risk of rupture and bleeding of the aneurysm, which can be difficult to treat if there is severe bleeding. If there is some coronary artery dilation, it can lead to the formation of coronary artery thrombosis, which is also a complication it can cause. However, the vast majority of Kawasaki disease cases, if treated effectively, can prevent coronary artery abnormalities. Therefore, as long as the treatment is timely, most cases will not have significant lasting effects.

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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.