Treatment Guidelines For Kawasaki Disease: What You Should Know

Treatment For Kawasaki Disease

Kawasaki disease usually needs prompt medical attention and is treated with a high dose of aspirin and intravenous immunoglobulin. Once the fever caused by this condition comes down, the dosage of aspirin will be reduced. Those who develop heart complications may need blood thinners and, in rare cases, surgical procedures.

Kawasaki disease is a rare illness involving the inflammation of blood vessels across the body. It usually affects children under 5 years of age while adults get it very rarely. The characteristic signs of this disease include a fever which lasts longer than 5 days, swollen and tender glands in the neck, peeling skin, cracked dry lips, red eyes, red toes or fingers, a red, swollen or bumpy tongue (strawberry tongue), and a rash. Kawasaki disease needs to be treated with caution because it can affect the coronary arteries and lead to serious heart problems. In fact, up to 5% of the children who get this disease develop heart complications.

Kawasaki Disease Needs Prompt Medical Attention

The exact cause of Kawasaki disease is not yet known. It is thought that a viral or bacterial infection combined with a genetic predisposition to the condition may be responsible.

Diagnosis of Kawasaki disease involves a physical and a urine and blood test to check for inflammation, anemia, etc., and rule out other illnesses. An ECG and EEG may also be recommended to check how the heart is faring. Once confirmed, Kawasaki disease typically requires hospital treatment, both to monitor for complications and because of the nature of the medicines administered.

It’s best to start the treatment as soon as possible – this can reduce recovery time as well as the risk of complications. Ideally, treatment should be started within 10 days of the start of symptoms. The good news is that most children recover completely within 6–8 weeks if this disease is treated promptly.

Treatment Aims At Reducing Fever And Inflammation And Preventing Heart Damage

Kawasaki disease poses the risk of acquired heart disease in children, which is why prompt medical treatment is critical.

Medication is usually used to treat Kawasaki disease, though in rare cases, medical procedures and even surgery may be required to deal with heart problems. The immediate objective is to reduce inflammation and fever and prevent the disease from damaging the coronary arteries.1 2 3

While natural remedies like tulsi leaves may help tackle fever and other discomfort associated with Kawasaki disease, this rare condition needs prompt and intensive medical attention, especially in the initial window after diagnosis. Any delay in treatment can leave the person vulnerable to serious heart complications.

High Doses Of Aspirin Are Administered Initially

While aspirin is generally a no-no for children, the treatment for Kawasaki disease involves high doses of aspirin, a non-steroidal anti-inflammatory drug (NSAID), in the initial stages. Aspirin can ease fever and reduce discomfort and pain. At high doses, it also lessens swelling or inflammation. When the fever caused by Kawasaki disease abates, a lower dose of aspirin is prescribed for a period of about 6 to 8 weeks from the beginning of symptoms. The low dose is meant to help stop blood clots from forming in the arteries.

Make sure your child gets plenty of rest and fluids when they have a fever. Keep their room at a comfortable temperature and dress them in light clothes. Remember that aspirin is never to be given to a child below the age of 16 unless it’s prescribed by a doctor as it can have serious side effects.4

But giving children aspirin comes with its own risks. Aspirin is not usually recommended for children below the age of 16 because it can increase the risk for Reye’s syndrome. While a rare condition, Reye’s syndrome can lead to serious brain and liver damage. While Kawasaki disease is an exception to the no-aspirin-for-children rule, it’s still a tightrope walk. The child will need to be watched closely to ensure there is no fallout. Alert your doctor immediately if your child has symptoms like tiredness, loss of energy, repeated vomiting, seizures, and rapid breathing which can point to Reye’s.5 6 Since the risk of Reye’s syndrome is particularly high if aspirin is used by children who have chickenpox or influenza, your doctor may stop treatment with aspirin temporarily if your child is exposed to or has these conditions.7

IVIG Can Help Reduce Fever And Risk of Heart Problems

Children who have been given immunoglobin need to wait for 11 months before being vaccinated for chickenpox or measles as immunoglobin can prevent these vaccines from working properly.8

An immunoglobulin known as gamma globulin can help treat Kawasaki disease. Immunoglobins are antibodies produced by the immune system to fight germs. It is obtained from healthy donors and administered intravenously to the patient. Intravenous immunoglobulin (IVIG) can ease fever and lower the risk of heart problems in those with Kawasaki disease. Typically, you should see an improvement in symptoms within 36 hours of giving this medicine. If the fever doesn’t come down in 36 hours, a second dose may be suggested.

Corticosteroids Are Used As Supplementary Treatment

While the possibility of heart complications makes Kawasaki disease a terse and anxious episode for any parent, know that this is a treatable condition when caught promptly. The chances of preventing heart disease are also high with close initial monitoring.

Corticosteroids are medicines that closely resemble hormones and are usually used when a second dose of intravenous immunoglobin doesn’t prove to be effective. In some cases, when a child has a high chance of developing heart problems, corticosteroids may be used as part of the initial treatment.

Heart Complications, If Any, Will Need To Be Addressed

If Kawasaki disease causes the development of a heart abnormality, your child may need medication, medical procedures, or surgery to address it. Treatments may include:

Blood Thinning Medicines

Antiplatelet and anticoagulant medicines stop the clotting of blood. These blood thinners are prescribed if the arteries are especially inflamed. They can ward off a heart attack which may be brought on by the formation of a blood clot that blocks blood flow to the heart. They are typically stopped once the coronary arteries heal.

Medical Procedures Such As Surgery

In rare cases, inflammation can cause arteries to become narrow and result in heart problems which require medical procedures such as surgery. Coronary angioplasty is a procedure which widens narrowed or blocked arteries so that blood flow to the heart is improved. In some cases, a stent or hollow metal tube is placed into a blocked artery in order to keep it open. A coronary artery bypass is a surgical procedure used to improve blood flow to the heart. Blood is bypassed or diverted around clogged or narrow arteries in the procedure.

Long-Term Management Required If Coronary Arteries Are Affected

Heart complications due to Kawasaki disease can increase the risk of developing conditions such as heart disease and heart attacks later on in life. Severe complications may mean permanent damage to heart valves or muscles which may need to be monitored long-term by a heart specialist. Children with serious complication may need to undergo routine tests such as an electrocardiogram or a stress test to check the health of their heart. Even otherwise, following a heart-healthy diet and lifestyle may be particularly important for children who have had Kawasaki disease to minimize chances of heart disease later.9

References   [ + ]

1. Kawasaki disease. National Health Service.
2, 8. Kawasaki Disease. National Institutes of Health.
3, 6. Treatment. National Health Service.
4. Fevers. Nemours Foundation.
5. Reye’s syndrome. National Health Service.
7. Kawasaki Disease. Merck Manual.
9. Complications. National Health Service.

Disclaimer: The content is purely informative and educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.