Kawasaki Disease: No Link to Travolta Death
Childhood Kawasaki Disease Unlikely Cause of Seizures in Travolta's Teenage Son Jett Travolta
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Kawasaki Disease: Mysterious Ailment on the Rise continued...
The classic symptom of Kawasaki disease -- technically known as mucocutaneous lymph node syndrome -- is a high fever lasting for five days or longer. Other symptoms include:
Pinkeye (conjunctivitis) in both eyes, but without purulent discharge.
- Redness of the lips, tongue, and lining of the mouth. Lips are often cracked or bleeding.
- A swollen cervical lymph node larger than 1.5 millimeters in diameter.
- A red rash on the body, which may be flat or bumpy and which may have different patterns.
- Changes in the extremities: swollen hands and feet with redness of the palms and soles. In the second week of illness, there may be peeling of the skin starting around the fingernails and extending to the arms.
Kawasaki disease is diagnosed when a child has five days of high fever and any four of the five symptoms listed above.
There may be other troublesome features, Litman says: swelling of the gallbladder, diarrhea, and painful swelling of the joints. But the scariest thing about Kawasaki disease is its possible effects on the heart.
Kawasaki Disease and Heart Trouble
"The most troublesome feature of Kawasaki disease is involvement of the heart," Litman says. "What worries everyone is that in the convalescent phase, about 10 days into the illness, there may be inflammation of the coronary arteries, which can result in aneurysm formation. This can cause turbulence throughout the artery and cause [narrowing] of the artery, which could cause a heart attack."
If not treated, one in five children with Kawasaki disease would get coronary aneurysms. Fortunately, treatment cuts this risk to about one in 20.
Treatment involves a high dose of immune globulin and a high-dose aspirin until the fever goes down. Once the fever goes away, the child's aspirin dose is reduced and doctors perform an echocardiogram to check for heart abnormalities.
"This generally results in a return to a happy state," Litman says. "In kids who do develop aneurysms, some may resolve, but this may still be a forerunner of adult-type coronary artery disease. They may be left with residual stenosis [narrowing of a heart artery] that can cause a future heart attack."