Kawasaki Disease Treatment in Delhi, India

Kawasaki Disease is a rare but serious condition that primarily affects children under the age of five. It causes inflammation in the walls of medium-sized arteries throughout the body, including the coronary arteries, which supply blood to the heart muscle. Early detection and treatment are crucial to prevent long-term complications and ensure a healthy recovery.

The exact cause of Kawasaki Disease is still unknown. However, it is believed to result from an abnormal immune system response, possibly triggered by a viral or bacterial infection. While not contagious, the condition requires immediate medical attention to prevent complications.

Certain risk factors may increase the likelihood of developing Kawasaki Disease:

Age

Kawasaki Disease most commonly affects children under the age of five, with the highest incidence occurring between 1 and 2 years old. Although it can occur in older children or, in rare cases, adolescents, younger children are at the greatest risk of developing complications if not diagnosed and treated early.

Gender

Boys are slightly more at risk of developing Kawasaki Disease than girls. Studies suggest that male children have a higher incidence rate, although the reason for this gender difference is not yet fully understood.

Ethnicity

Children of Asian descent, particularly those of Japanese or Korean heritage, have a significantly higher susceptibility to Kawasaki Disease. It is more prevalent in countries like Japan, where extensive research has been conducted to understand its genetic and environmental triggers. However, the disease can affect children of any ethnic background.

The symptoms of Kawasaki Disease typically appear in two distinct phases. Early identification of these signs is essential to begin treatment promptly and reduce the risk of complications.

Common symptoms include:

• High fever: Lasting for five days or more and unresponsive to medication.
• Skin rash: Often appearing on the chest, abdomen, and groin.
• Swollen hands and feet: Accompanied by redness and peeling of the skin.
• Red eyes: Without discharge, also known as conjunctivitis.
• Strawberry tongue: Red, swollen tongue with prominent bumps.
• Swollen lymph nodes: Usually in the neck area.

Second-phase symptoms may include:

• Peeling skin, particularly on the hands and feet.
• Joint pain or swelling.

If your child shows any of these symptoms, consult a doctor immediately for a thorough evaluation.

Diagnosing Kawasaki Disease requires a thorough evaluation of symptoms and a series of tests to confirm the condition while ruling out other illnesses. Since there is no single test for Kawasaki Disease, doctors rely on a combination of clinical assessments and diagnostic procedures to make an accurate diagnosis.

Physical Examination

A detailed physical examination is the first step in diagnosing Kawasaki Disease. Doctors check for key symptoms such as prolonged fever, skin rashes, red eyes, swollen lymph nodes, and inflammation of the lips and tongue. Since these signs can resemble other childhood illnesses, a careful assessment is essential to differentiate Kawasaki Disease from infections or autoimmune conditions.

Blood Tests

Blood tests help detect markers of inflammation, such as elevated white blood cell count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Additionally, abnormal platelet levels and signs of anaemia may indicate Kawasaki Disease. These tests not only support the diagnosis but also help monitor the child’s response to treatment.

Urine Tests

Urinalysis is conducted to rule out bacterial or viral infections that may cause similar symptoms. In some cases, Kawasaki Disease can lead to mild urinary abnormalities, which further support the diagnosis when combined with other findings.

Echocardiogram

An echocardiogram is a crucial imaging test used to evaluate the heart and coronary arteries. Since Kawasaki Disease can cause inflammation and damage to these blood vessels, this test helps identify any signs of coronary artery dilation or aneurysms. Early detection of heart complications allows doctors to initiate timely treatment and reduce the risk of long-term cardiac issues.

Early treatment is crucial in managing Kawasaki Disease and preventing severe complications, particularly those affecting the heart. Usually, treatment is most effective when started within the first 10 days of symptom onset. So, it is important to seek medical attention as soon as symptoms appear.

Common treatment approaches to Kawasaki Disease include:

Intravenous Immunoglobulin (IVIG)

IVIG is the first-line treatment for Kawasaki Disease and is administered through an intravenous infusion. It helps reduce inflammation and significantly lowers the risk of coronary artery complications when given within the first 10 days of symptom onset. This treatment is highly effective in most cases and plays a vital role in preventing long-term heart damage.

Aspirin Therapy

Aspirin is used in different doses throughout the treatment process. Initially, high doses help reduce fever and inflammation, while lower doses are continued over several weeks to prevent blood clot formation. This is one of the few paediatric conditions where aspirin is recommended, as its benefits outweigh the potential risks when monitored by a doctor.

Corticosteroids

In cases where IVIG does not provide the expected response, corticosteroids may be prescribed as an additional treatment. These powerful anti-inflammatory medications can help manage severe cases and improve outcomes, especially in children at higher risk of complications.

Hospitalisation and Monitoring

Since Kawasaki Disease can have serious effects on the heart, hospitalisation is often required during the initial phase of treatment. Close monitoring allows doctors to assess the child’s response to therapy, conduct necessary heart evaluations, and adjust treatment plans as needed to ensure the best possible recovery.

If left untreated or diagnosed too late, Kawasaki Disease can lead to serious complications, particularly involving the heart and blood vessels. Early diagnosis and treatment significantly reduce the risk of long-term issues.

Potential complications include:

• Coronary artery aneurysms: The most common and serious complication, which can lead to heart attacks and long-term heart damage.
• Heart failure: Resulting from damage to the heart’s coronary arteries, which affects the heart’s ability to pump blood effectively.
• Arrhythmias: Abnormal heart rhythms caused by damage to the heart’s electrical system.
• Joint problems: Some children may experience arthritis or joint pain during or after recovery.

With proper treatment, the majority of children recover without lasting complications, but close follow-up care is essential to monitor heart health.

Currently, there is no known way to prevent Kawasaki Disease, as the exact cause remains unidentified. However, early detection and prompt treatment can greatly reduce the risk of serious complications, particularly those affecting the heart.

Preventive measures include:

• Early diagnosis: Timely medical intervention is the most effective way to reduce the risk of complications.
• Heart monitoring: Regular follow-up appointments, including echocardiograms, may be recommended to monitor heart health, especially if complications like coronary artery aneurysms are suspected.
• Vaccinations and hygiene: While not directly linked to Kawasaki Disease, maintaining general health through vaccinations and good hygiene can help prevent infections that may trigger immune system responses.

Although Kawasaki Disease cannot be entirely prevented, timely care and ongoing monitoring are key to ensuring a healthy recovery and minimising risks.

How long does it take for a child to recover from Kawasaki Disease?

Most children recover within a few weeks with appropriate treatment. However, follow-up care is essential to monitor for any long-term effects, especially concerning heart health.

Can Kawasaki Disease affect adults?

Kawasaki Disease is rare in adults, but it can occur. It is most commonly diagnosed in children under the age of five, though adult cases may involve different symptoms and complications.

How often should a child who has Kawasaki Disease be monitored for heart health?

After recovery, children should have regular check-ups, including echocardiograms, to monitor heart health. The frequency of these tests will depend on the severity of the disease and the development of any complications.

Can Kawasaki Disease be fatal?

While Kawasaki Disease itself is rarely fatal, the risk of severe complications, particularly coronary artery damage, can lead to life-threatening conditions like heart attacks. Early treatment reduces this risk.

Are there any long-term effects of Kawasaki Disease on a child’s health?

While many children fully recover with no long-term effects, some may experience ongoing heart issues. Regular follow-ups are crucial to monitor heart function and detect any potential problems early.

Does Kawasaki Disease affect a child’s development?

Most children who recover from Kawasaki Disease grow and develop normally. However, if complications affect the heart, further medical attention and support may be required to ensure healthy development.

Is there a genetic predisposition to Kawasaki Disease?

While the exact cause is unknown, certain genetic factors may make some children more prone to Kawasaki Disease, especially those of Asian descent. However, there is no definitive evidence linking specific genes to the condition.

Can Kawasaki Disease recur?

Recurrence of Kawasaki Disease is very rare, but it has been reported in some cases. If a child has had Kawasaki Disease, it’s important to continue regular check-ups with a healthcare provider to monitor their health.

Can other conditions be mistaken for Kawasaki Disease?

Yes, several conditions, such as viral infections or other autoimmune diseases, can present with symptoms similar to those of Kawasaki Disease. A thorough medical evaluation helps distinguish between them.

How can I support my child emotionally during Kawasaki Disease treatment?

It’s important to provide emotional support to your child, as the disease and its treatment can be overwhelming. Encourage open communication, comfort, and reassurance, and involve your child in age-appropriate activities to reduce stress and anxiety.

Is Kawasaki Disease contagious?

No, Kawasaki Disease is not contagious. It is an immune system response to an unknown trigger, and it does not spread from person to person.

What is the risk of coronary artery problems after Kawasaki Disease treatment?

With early and effective treatment, the risk of coronary artery problems is significantly reduced. However, some children may still experience long-term heart issues, such as coronary artery aneurysms, which require regular monitoring.

How is Kawasaki Disease related to other inflammatory diseases?

Kawasaki Disease is an inflammatory condition, similar in some ways to other autoimmune diseases. However, it specifically affects the arteries and can lead to heart-related complications if not treated promptly.

What should I do if my child develops a fever after Kawasaki Disease treatment?

If your child develops a fever after treatment for Kawasaki Disease, contact your healthcare provider immediately. A fever could indicate a possible infection or a recurrence of symptoms, requiring further evaluation.

Can Kawasaki Disease be treated with antibiotics?

No, Kawasaki Disease is not caused by a bacterial infection, so antibiotics are not effective. The primary treatment for Kawasaki Disease is intravenous immunoglobulin (IVIG) to reduce inflammation and prevent heart complications.

Are there any specific lifestyle changes required after Kawasaki Disease recovery?

Most children can resume normal activities after recovery. However, if there are any heart-related complications, your child may need to avoid certain strenuous activities and follow specific recommendations from their healthcare provider.

Reviewed By Dr. Sanjeev Sehgal, Senior Consultant, Paediatrics (Ped), on 27 February 2025.