Early diagnosis of Kawasaki disease can reduce risk of cardiac complications
DR Puneet A Pooni, Professor and Head of the Department of Paediatrics at Dayanand Medical College and Hospital (DMCH), shares her insights on Kawasaki disease, a rare condition that causes inflammation in the blood vessels and primarily affects children under five, in conversation with Manav Mander.
n What is Kawasaki disease?
Kawasaki disease is the most common cause of acquired heart disease in children. It is a form of vasculitis, meaning inflammation of the blood vessels. Though serious, most children can fully recover if treated promptly. Also known as Kawasaki syndrome or mucocutaneous lymph node syndrome, the disease causes inflammation in the walls of small to medium-sized blood vessels throughout the body, often involving the coronary arteries, which supply oxygen-rich blood to the heart.
n What causes it?
Kawasaki disease occurs when the immune system mistakenly attacks the blood vessels. The exact cause remains unknown. Researchers suspect a combination of genetic factors and environmental triggers such as infections. It is important to note that Kawasaki disease is not contagious and children cannot pass it on to others.
n What are the symptoms of the disease?
Kawasaki disease is suspected if fever persists beyond 5 days with no focus and along with any four of the five criteria, though in a typical KD all criteria may not be met. The most common symptoms include lymph node swelling in the neck, strawberry tongue, oral ulcers, redness in eyes without eye discharge, rash on skin, which can be transient, some swelling of hands or feet, and later peeling of skin on hands or feet or anal region may occur.
n What complications can the disease cause?
The disease can affect the coronary arteries, leading to bulging or thinning of the arterial walls and increasing the risk of blood clots. If untreated, this may result in a heart attack or internal bleeding. Kawasaki disease can also impact the brain and nervous system, immune system and the digestive tract.
n What is the recommended treatment?
Aspirin is needed for a few weeks or as long as the heart vessels are involved and the child requires frequent echocardiography. Early intervention—ideally within 10 days of fever onset—is essential to reduce the risk of cardiac complications.
n Has DMCH launched any special initiative for Kawasaki disease?
Yes, the DMCH has introduced a dedicated Kawasaki disease clinic, held every second Saturday at the Paediatric OPD. The clinic focuses on early diagnosis and standardised treatment. Prompt treatment within the first 10 days using IVIG significantly lowers the risk of long-term heart damage. Our goal is to ensure that no child suffers due to delayed diagnosis.
Ludhiana