Download Kawasaki Disease: Not just Japanese Motorbike Aficionados

Kawasaki Disease: Not just Japanese Motorbike Aficionados
Shirley Mates* & Debbie Neill
Kawasaki Disease is an acute febrile illness that predominantly involves the skin, mouth,
and lymph nodes, and typically affects children who are under the age of 5. The cause of
Kawasaki Disease is unknown, but if symptoms are recognized early and treatment
instituted, children with the disease will generally recover. Untreated, up to one quarter
of children develop serious complications affecting the coronary arteries. Of these,
aneurysms of the coronary arteries are the most serious and may lead to heart attack
and long term problems.
The symptoms of Kawasaki Disease typically appear in phases. The first ‘acute’ phase
can last up to 2 weeks and usually involves a persistent fever that is often higher than
390C which lasts for at least 5 days. The other features that typically develop include:
 severe redness in the eyes without discharge
 a rash on the child's stomach, chest, and around the nappy area
 red, dry, cracked lips
 swollen tongue with a white coating and big red bumps (‘strawberry tongue’)
 sore, red throat
 swollen palms of the hands and soles of the feet, often with a purple-red color
 swollen lymph node usually in the neck
Classically the diagnosis of Kawasaki disease is made by the presence of at least four of
these clinical features and a fever of at least five days. In about 15-20% of children, less
than four features are present. This is called ‘incomplete Kawasaki disease’ and so the
diagnosis should be considered in any young child with a prolonged and unexplained
fever.
In addition, the child with Kawasaki disease is often more irritable than is usual in a
childhood infection. The child may also experience joint pain, diarrhea, vomiting, or
abdominal pain. It is important to note that the features of Kawasaki disease may
develop sequentially over a few days and are not usually all present at once.
During the second phase of the illness, usually beginning within two weeks of when the
fever first begins, the skin on the child's hands and feet may begin to peel in large pieces
and nails may discolour and curl.
Usually, if Kawasaki disease is treated within 10 days of when the first symptoms begin,
heart problems develop in about 5% of children. But if the illness goes untreated (time
period can vary, but likely for 10-14 days and sooner in young infants), coronary artery
damage may occur in up to 25% of children. In addition it can lead to more serious
complications including inflammation of the heart muscle, lining, damage to the heart
valves, or the outer membrane that surrounds the heart and arrhythmias or abnormal
functioning of some heart valves.
The Kawasaki Disease Foundation has compiled ‘A Survival Guide for Parents, by
Parents’ along with various other information resources to support parents of children
diagnosed with Kawasaki Disease. A number of research projects on Kawasaki disease
are being led by Dr David Burgner, Paediatric Infectious Diseases Physician in Western
Australia, together along with several international researchers. Dr Burgner is also
medical Advisor to The Kawasaki Disease Foundation. Over 300 Australian families
have joined a study on genetic factors in Kawasaki Disease. If you and your family are
interested in participating in these studies or would like more information, please contact
David Burgner ([email protected])
The Kawasaki Disease Foundation can be contacted by email: [email protected]
or via www.kdfoundation.org.au
*Shirley Mates, her family, Aylee Sunstrom, Kathleen Pennicard and Jennifer Joseph
have developed the Australian Kawasaki Disease Foundation to support families, raise
awareness and continue research.