Kawasaki disease is an acute febrile inflammatory disease of the blood vessels that is self-limiting. Although, the disease is self-limiting and rare recurrence has been noted once a child is inflicted by it, there are serious cardiac complications that one should be wary of including coronary cardiac aneurysm, myocardial infarction and sudden death. Therefore, it is imperative to recognize the symptoms and diagnose the disease as early as possible and treat it. Although, with treatment total risk of cardiac complications is not eradicated, it is significantly reduced from 25% to 35%.
The disease is more commonly noted in people of Japanese descent, it is 10 times more common in Japan than in the United States. It is also more common in males than in females. Since, no known cause has been identified, although, there has been a strong implication of infectious and genetic factors, no prevention can be maintained due to unknown nature of the disease.
Natural Remedies For Kawasaki Disease
Usually, IVIG and aspirin therapy suffices in most patients and they recover without cardiac complications. There has been a question in peoples mind whether there are alternative therapies or natural remedies to address this disease state. The answer is there is no alternative therapy or any natural treatment for Kawasaki disease. There has been a study in which the use of traditional Chinese medicine, Qing Re Liang Xue decoction was studied in addition to IVIG therapy. The result showed improvement in thrombocytosis and inflammatory course of the disease. Although, traditional Chinese medicine was used in these patients, it was used along with IVIG. Therefore, IVIG forms the mainstay of treatment for Kawasaki disease until date and there is no alternative therapy for it. (1)
Kawasaki disease is accompanied by high fever (around 102-104 degree F) that often spikes and remits lasting 1-2 weeks. However, the fever does not resolve with the use of antipyretics, like Tylenol. It is often accompanied by other symptoms including bulbar conjunctivitis, diffuse maculopapular rash in the body, erythema, fissuring , bleeding or crusting of lips, erythema of oral mucosa, erythema and smoothening of the tongue, erythema of the soles and palms of extremities, desquamation of the toes and fingers, and cervical lymphadenopathy (lymph node size at least 1.5 cm). It can also be accompanied by irritability, arthralgia and cardiac lesions may pursue in some patients.
The course of the disease is divided basically into three parts, namely, acute, subacute and convalescent. Some authors add a fourth course known as chronic phase. Acute phase is symbolic of high fever along with other symptoms, whereas in subacute phase the fever subsides, though other symptoms may persist. This phase is the most dangerous phase as most cardiac symptoms occur in this phase and can lead to MI and sudden death. In convalescent phase, there is resolution of symptoms. The chronic phase is marked with cardiac complications and is significant for only those who have developed cardiac complications. It is present for life.
There are no specific tests for confirming Kawasaki disease. The lab tests and imaging studies are carried out to rule out other diseases and to look for cardiac complications. Echocardiogram is the imaging of choice for coronary artery aneurysm. During the active diseased state, abnormal CBC will be noted along with anemia and thrombocytosis.
The first line treatment of Kawasaki disease is intravenous gammaglobulin along with aspirin to reduce the inflammation and fever. The goal of treatment is to reduce the chances of and prevent cardiac complications, mainly coronary artery aneurysms. The main reason for infusing IVIG is to reduce cardiac complications and it reduces that from 25% in untreated cases to 3-5% risk when treated. Maximum benefit is noted when it is given within 10 days of fever onset. For IVIG resistant disease, treatment with infliximab is carried out. Monitoring of cardiac complications is imperative in Kawasaki patients along with long term use of low dose aspirin to prevent coagulation.
Patients allergic to aspirin can be given clopidogrel.
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