Rare Diseases 2022

Doença from Kawasaki: what é, symptoms and treatment

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Doença from Kawasaki: what é, symptoms and treatment
Doença from Kawasaki: what é, symptoms and treatment

Kawasaki disease is a rare childhood condition characterized by inflammation of the blood vessel wall leading to blotchy skin, fever, enlarged lymph nodes, and, in some children, heart and joint inflammation.

This disease is not contagious and occurs more frequently in children up to 5 years of age, especially in boys. Kawasaki disease is typically caused by changes in the immune system, which causes the immune cells to attack the blood vessels themselves, leading to inflammation. In addition to the autoimmune cause, it can also be caused by viruses or genetic factors.

Kawasaki disease is curable when identified and treated quickly, and treatment should be done according to the pediatrician's guidance, which, in most cases, includes the use of aspirin to relieve inflammation and injection of immunoglobulins to control the autoimmune response.

Main signs and symptoms

The symptoms of Kawasaki disease are progressive and can characterize three stages of the disease. However, not all children show all symptoms. The first stage of the disease is characterized by the following symptoms:

  • High fever, usually above 39ÂșC, for at least 5 days;
  • Irritability;
  • Red eyes;
  • Red, cracked lips;
  • Tongue swollen and red like strawberry;
  • Red Throat;
  • Glues on the neck;
  • Red palms and soles of feet;
  • Red spots on the skin, especially on the torso and in the diaper area.

In the second stage of the disease, the skin starts to flake off on the fingers and toes, joint pain, diarrhea, stomach ache and vomiting that can last for about 2 weeks.

In the third and final stage of the disease, the symptoms slowly begin to regress until they disappear.

What is the relationship with COVID-19

To date, Kawasaki disease is not considered a complication of COVID-19. However, and according to observations made in some children who test positive for COVID-19, especially in the United States, it is possible that the childhood form of infection with the new coronavirus causes a syndrome with symptoms similar to Kawasaki disease, namely the fever, red spots on the body and swelling.

Learn more about how COVID-19 affects children.

How to confirm the diagnosis

The diagnosis of Kawasaki disease is made according to the criteria established by the American Heart Association. Thus, the following criteria are evaluated:

  • Fever for five days or more;
  • Pus-free conjunctivitis;
  • Presence of red and swollen tongue;
  • Redness and swelling of the oropharynx;
  • Visualization of fissures and redness of the lips;
  • Redness and swelling of hands and feet, with scaling in the groin area;
  • Presence of red spots on the body;
  • Swollen glands in the neck.

In addition to the clinical examination, exams may be requested by the pediatrician to help confirm the diagnosis, such as blood tests, echocardiogram, electrocardiogram or chest X-ray.

How the treatment is done

Kawasaki disease is curable and its treatment consists of the use of medication to reduce inflammation and prevent the worsening of symptoms. Treatment is usually done with the use of aspirin to reduce fever and inflammation of blood vessels, especially the arteries of the heart, and high doses of immunoglobulins, which are proteins that are part of the immune system, for 5 days, or according to with medical advice.

When fever has subsided, use of small doses of aspirin can be continued for a few months to reduce the risk of damage to the heart arteries and clot formation. However, to avoid Reye's Syndrome, which is a disease caused by prolonged use of aspirin, Dipyridamole can be used according to the pediatrician's guidance.

Treatment should be carried out during hospitalization until there are no risks to the child's he alth and no possibility of complications, such as heart valve problems, myocarditis, arrhythmias or pericarditis. Another possible complication of Kawasaki disease is the formation of aneurysms in the coronary arteries, which can lead to obstruction of the artery and, consequently, infarction and sudden death. See what are the symptoms, causes and how an aneurysm is treated.

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