Kawasaki Disease Prognosis

A large majority of children who develop Kawasaki disease recover within two weeks and experience no long-lasting effects. As many as 25 percent of sufferers may develop heart problems, but that percentage drops dramatically to below 5 percent with quick treatment. Only about 1 percent of cases prove fatal, but because that possibility exists, you must know what symptoms to watch for and what steps to take to prevent immediate and future complications.

Symptoms

• Kawasaki disease is also known as infantile polyarteritis and mucocutaneous lymph node syndrome. These longer alternate names indicate that Kawasaki disease involves the swelling of blood vessels all over the body, especially around the heart, and that many of the disease's symptoms involve lymph nodes, mucous membranes and skin.
  Children, especially boys of Asian heritage between the ages of 2 and 5, are at greatest risk for Kawasaki disease. Around 4,200 U.S. children are diagnosed with Kawasaki each year.
  If your child runs a fever of 101.3 F (38.5 C) for four days, he or she may have Kawasaki. High, sustained fever that does not respond to acetaminophen or ibuprofen might also signal measles, Rocky Mountain spotted fever or scarlet fever, so make an appointment with your pediatrician as soon as possible.
  According to the Kawasaki Disease Foundation, symptoms come in two waves. Things to watch for during the first wave are
  • Rash, especially around the genitals, not marked by blisters
  • Red eyes (conjunctivitis)
  • Red, cracked lips
  • Shiny, spotted tongue (i.e., "strawberry tongue")
  • Swollen hands with red palms
  • Swollen feet with red soles
  • Swollen lymph nodes

  Second-wave symptoms include
  • Abdominal pain
  • Diarrhea
  • Peeling skin around the fingers and toes
  • Temporary arthritis
  • Temporary hearing loss
  • Vomiting

  Perhaps unnecessarily, a KDF pamphlet observes, "Children with these symptoms are extremely uncomfortable and irritable."
  A diagnosis of Kawasaki disease requires the presence of at least four of these symptoms, plus the fever. Even without diagnosis and treatment, Kawasaki symptoms generally clear up within 12 days.

Initial Treatment

• If your child has Kawasaki disease, he or she will be admitted to the hospital to receive high-dose aspirin and intravenous gamma globulin. The aspirin will bring down the fever, while the gamma globulin will help reduce the swelling of the blood vessels and help prevent heart problems.
  Expect a hospital stay of a few days, during which your child will be monitored for the development of problems such as irregular heartbeat (arrhythmia), coronary artery swelling (aneurysm) and heart inflammation (myocarditis).

Longer-Term Treatment

• After returning home, your child will have to continue taking low doses of aspirin for as long as eight weeks. Your child may also have to take medications to treat the temporary arthritis or control heart conditions.
  You will also have to monitor your child's temperature every day for up to two weeks and take your child for follow-up monitoring of his or heart health.

Support

• The KDF sponsors an online forum titled Family Stories that you can access from the foundation's homepage. The foundation also operates the KD Bridges program, which matches families experiencing Kawasaki disease with volunteers who can share their own experiences to help families cope.

A Note on Aspirin

• A Kawasaki disease fact sheet from the Mayo Clinic notes, "Kawasaki treatment is a rare exception to the rule against aspirin use in children."
  In children up to 18 years of age, aspirin use increases the risk of developing Reye's syndrome. Symptoms of Reye's syndrome include vomiting, disorientation, fainting and severe headache. Children can die quickly from organ failure if Reye's syndrome is not recognized and treated within hours of symptom onset, and survivors often incur brain damage.
  Never give aspirin or a combination drug product containing aspirin to your child unless your physician determines that the benefits of aspirin therapy outweigh the risks.