How Do You Treat Kawasaki Disease?
Kawasaki disease occurs in children below 5 years of age and is the condition present by inflammation in the blood vessels all over the body. Various treatment strategies are adopted to manage the symptoms.
How Do You Treat Kawasaki Disease?
Although the condition is rare and the symptoms are frightening and widespread, the condition is treatable by properly strategizing the treatment. The goal of the treatment is to manage the signs and symptoms and also reducing the risk of heart complications. The treatment should start as early as possible, just after the initial symptoms such as fever emerges, after proper diagnosis. It should be noted that all the patients suffering from Kawasaki disease should be admitted to the hospital for Intravenous administration of immunoglobulin, initiation of aspirin, echocardiography and till the fever subsides.
Following are the treatment options available for the treatment of Kawasaki Disease:
- Intravenous Immunoglobin (IVIG): The Acute inflammation of the vascular system is significantly reduced after administration of intravenous immunoglobin and the risk of coronary artery aneurysms is lowered. The earlier the treatment started, the better is the control over the management of symptoms. Generally, the treatment with IVIG should be started within 5-7 days after the onset of fever. In the initial studies and clinical practice, lower dose with increased frequency for the larger time period was recommended. However, with the advanced clinical trials, it has been found that a high dose with low frequency is more effective. While almost 25% of the untreated patient may suffer coronary artery aneurysms whereas only 2-3% of the treated people have the risk of occurring coronary artery aneurysms. (1)
- Treatment Of IVIG-Resistant Disease: Almost 15% of the patient does not respond to the treatment with IVIG. The criterion for failure of the therapy is fever remains for more than 36 hours even after the treatment have been started. In such cases, the second round of administration is repeated. However, few of the patients still do not respond to treatment. According to the guidelines of AHA, in such patients, the dose of IVIG, methylprednisolone, and a tapering course of prednisolone can be given. Alternatively, infliximab can also be considered in such patients.
- Aspirin: Aspirin is a standard therapy for the patients of Kawasaki disease. Some physicians start with a high dose of aspirin for a particular period and then taper the dose and sustain it for the rest of the treatment period. Aspirin is initiated as soon as the patient has no fever for at least 48-72 hours.
- Other Adjunctive Agents: Although the research does not provide any conclusive result for the use of steroids, corticosteroids can be used in IVIG-resistant cases.
In 1967, a Japanese pediatrician, Tomisaku Kawasaki, described a rare and strange disease in children characterized by the presence of fever, enlarged nodes, red eyes and other body parts and rashes in the genital area. The condition is caused due to inflammation in the blood vessels throughout the body. The disease was named after him and is known as Kawasaki disease. The occurrence of this disease is very less however, in Japan, the condition occurs relatively more. The exact cause remains unknown but the auto-immune malfunction is said to be the major contributor in the development of this disease. The disease involves various organs such as lymph nodes, mouth, and skin, and the condition is predominantly found in children with less than 5 years of age. People with older age rarely develop this disease. The risk factors include age, sex, and ethnicity. Boys are more likely to develop the condition as compared to girls. Further, the Asian origin children such as of Japan and Korea are more prone to this condition. The symptoms of the condition are sometimes frightening as it causes peeling of skin as well as severe rashes.
The treatment of Kawasaki disease starts with intravenous immunoglobin and patients who do not respond to this treatment may be given a combination of IVIG and steroids.