Kawasaki disease: symptoms, photo, treatment in children and adults

Kawasaki disease (Kawasaki syndrome, mucocutaneous lymph-syndrome) belongs to a group of diseases called "systemic vasculitis". Diseases of this group is caused by abnormal blood vessels damage to cells of the immune system, most often, the arteries and veins of medium and small size. In the case of Kawasaki syndrome, when it may damage the coronary artery in children - vessels carrying oxygenated blood and nutrients to the heart.

Furthermore coronary arteries, inflammation can cover the pericardial sac (pericardium), that surrounds the heart, as well as endocardial tissue (the inside of the heart), and even the very heart muscle.

Kawasaki's disease most commonly affects children - usually before the age of 5 years. She rarely exposed to older children and adults. The peak incidence reaches the age of 1 to 2 years, and is more common in boys.

What it is?

Kawasaki syndrome - an acute febrile illness of childhood characterized by lesions and other coronary vessels of the possible formation of aneurysms, thrombosis and vascular ruptures wall.

Causes of

Currently, rheumatology has no definitive data about the causes of Kawasaki disease.

The most accepted theory is the assumption that Kawasaki disease develops on the background of genetic predisposition influenced infectious bacterial agents (streptococcus, staphylococcus, rickettsiae) or virus (Epstein-Barr virus, herpes simplex virus, parvovirus, retrovirus) nature.

In favor of hereditary predisposition to the disease Kawasaki disease indicates connection with racial membership, its spread to other countries, mainly among Japanese immigrants, development of the disease in 8-9% of descendants convalescents persons.

The symptoms of Kawasaki disease

The most striking symptom of the syndrome, Kawasaki disease in children (see. photo) - fever lasting longer than 5 days. Also in the UK observed:

• increase in size of cervical lymph node;
• tongue swelling;
• acquisition of the language of scarlet hue;
• redness of the lips;
• cracks on the lips;
• rash polymorphic nature, localized anywhere on the body;

Approximately 2 weeks after the onset of fever, the child may appear seal flaky skin on the palms or soles.

During pathology are three stages, cyclically interchanging:

1. The acute stage lasts two weeks and is manifested by fever, asthenia and symptoms of intoxication. In the myocardium it develops an inflammatory process, it weakens and ceases to function.
2. Subacute stage thrombocytosis seen in the blood and symptoms of heart disorders - systolic murmur, muffled heart sounds, arrhythmia.
3. Recovery occurs by the end of the second month of the disease: symptoms disappear all pathology and normalized blood count parameters.

Kawasaki syndrome in adults is characterized by inflammation of the coronary vessels which cease to be elastic and swell in some areas. The disease leads to early atherosclerosis, calcification, thrombosis, and myocardial infarction dystrophy. Young people have an aneurysm will eventually become smaller and may eventually disappear.

Patients complain of pain in the heart, tachycardia, arthralgia, vomiting, diarrhea. In more rare cases, there are symptoms of meningitis, cholecystitis and urethritis, cardiomegaly, hepatomegaly.

Diagnostics

To put a Kawasaki syndrome diagnosis requires the presence of fever for more than 5 days and all 4 the following criteria

1. Erythema hands or feet;
2. Tight swelling hands or feet on the 3-5th day of illness;
3. Peeling at their fingertips on 2-3rd week of illness;
4. Bilateral conjunctival injection;
5. Changes on the lips or in the mouth, "strawberry" tongue, erythema or cracks on the lips, infection of the mucous membrane of the mouth and throat;
6. Any of these changes are localized on the limbs;
7. Polymorphic rash on the trunk, without bubbles or crusts;
8. Acute purulent cervical lymphadenopathy (diameter of a single lymph node> 1.5 cm).

If there are no 2-3 of 4 essential characteristics of the disease, a diagnosis of incomplete clinical picture of the disease.

complications

Kawasaki disease is a very difficult course and is often complicated by the development of serious violations:

1. myocarditis,
2. Acquired aortic and mitral insufficiency,
3. hemopericardium,
4. Otitis media,
5. Myocardial infarction,
6. Aneurysm rupture,
7. pericarditis,
8. Valvulita,
9. Acute and chronic heart failure.

Timely diagnosis and treatment of Kawasaki syndrome allowed to drastically reduce morbidity and infant mortality.

Treatment of Kawasaki disease

The main goal of medical therapy is to protect against attack cardiovascular system.

Good effect in Kawasaki disease give the following medications:

Aspirin	It has potent anti-inflammatory action and promotes liquefaction of the blood, so it is widely used for the treatment of Kawasaki disease.
immunoglobulin	administered intravenously once a day and allows the body to quickly deal with the disease by improving the passive immunity.
anticoagulants	for the prevention of thrombosis patients were administered anticoagulants, often klopilogel and warfarin.

With the development of complications of the cardiovascular system (stenosis, aneurysms, myocardial infarction) for children who have suffered acute and subacute stage of Kawasaki disease can be assigned angioplasty, coronary artery bypass grafting or coronary stent.

Forecast

Usually, 2-3 month course of the disease symptoms completely disappearing. After 4-8 weeks after the transverse grooves of white can be formed at the moment of the nail plate. If the disease is not treated, 25% of developing an aneurysm rupture.

Currently no cases of death make up 0.1-0.5%, which suggests a positive prognosis. In rare cases, about 3%, the disease can recur within a year after the treatment.