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Kawasaki disease is a rare childhood condition characterized by inflammation of the blood vessel wall leading to the appearance of spots on the skin, fever, enlarged lymph nodes and, in some children, cardiac and joint inflammation.
This disease is not contagious and occurs more frequently in children up to 5 years old, especially in boys. Kawasaki's disease is usually caused by changes in the immune system, which causes the defense cells themselves to attack blood vessels, 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 response autoimmune.
Main signs and symptoms
The symptoms of Kawasaki's disease are progressive and can characterize three stages of the disease. However, not all children have all symptoms. The first stage of the disease is characterized by the following symptoms:
- High fever, usually above 39 ºC, for at least 5 days;
- Irritability;
- Red eyes;
- Red and chapped lips;
- Tongue swollen and red as strawberry;
- Red throat;
- Neck tongues;
- Red palms and soles;
- Appearance of red spots on the skin of the trunk and in the area around the diaper.
In the second phase of the disease, there begins to be flaking of the skin on the fingers and toes, joint pain, diarrhea, stomach pain and vomiting that can last for close to 2 weeks.
In the third and last stage of the disease, the symptoms begin to regress slowly until they disappear.
What is the relationship with COVID-19
So far, Kawasaki's disease is not considered a complication of COVID-19. However, and according to observations made in some children who tested positive for COVID-19, especially in the United States, it is possible that the infantile form of infection with the new coronavirus causes a syndrome with symptoms similar to Kawasaki disease, namely 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;
- Conjunctivitis without pus;
- Presence of red and swollen tongue;
- Oropharyngeal redness and edema;
- Visualization of fissures and lip redness;
- Redness and edema of hands and feet, with flaking in the groin area;
- Presence of red spots on the body;
- Swollen nodes in the neck.
In addition to the clinical examination, tests may be ordered by the pediatrician to help confirm the diagnosis, such as blood tests, echocardiogram, electrocardiogram or chest X-ray.
How the treatment is done
Kawasaki's disease is curable and its treatment consists of the use of medicines to reduce inflammation and prevent the worsening of symptoms. Usually the treatment is done with the use of aspirin to reduce fever and inflammation of the blood vessels, mainly 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 with medical advice.
At the end of the fever, the use of small doses of aspirin may continue for a few months to reduce the risk of injury 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 done during hospitalization until there is no risk to the child's health and no possibility of complications, such as heart valve problems, myocarditis, arrhythmias or pericarditis. Another possible complication of Kawasaki's disease is the formation of aneurysms in the coronary arteries, which can lead to artery obstruction and, consequently, infarction and sudden death. See what are the symptoms, causes and how the aneurysm is treated.