Kawasaki disease causes inflammation in the arteries walls in the body and the inflammation further affects coronary arteries i.e. arteries responsible to supply blood towards the heart muscles of patients.
What Are The Stages Of Kawasaki Disease?
If we talk about the clinical course of kawasaki disease, it consists of four different phases or stages. These include the following-
Acute Phase/Stage of Kawasaki Disease- Acute phase/stage, which lasts for about 1week or 2weeks in children and in case, if you leave it untreated, your child experiences a huge spike in the body temperature or fever at about 40 degree Celsius. In addition, he/she experiences various principal symptomatic features and presents cardiac manifestations in the form of myocarditis, pericarditis and valvitis.
Sub-Acute Phase/Stage of Kawasaki Disease- Sub-acute phase of the disease lasts for approximately 2weeks followed by abatement of your child’s fever, when he or she remains at a higher risk related to sudden death because of myocardial infarction.
Convalescent Phase/Stage of Kawasaki Disease- Doctors call this as the clinically invisible phase/stage, convalescent phase/stage of Kawasaki disease follows the cessation of various Kawasaki disease symptoms and it continues until the reactants of your child’s acute phase returns to the regular serum levels.
Chronic Phase/Stage of Kawasaki Disease- Chronic phase or stage associated with Kawasaki Disease highlights those patients, who require follow-up and management because of their involvement of coronary arteries. (1)
Kawasaki Disease Management as Per Phases/Stages and Respective Complications
Kawasaki Disease Management at its Acute and Sub-Acute Phases
The main objective behind acute and sub-acute phases in Kawasaki Disease is to reduce the problem of inflammation, especially coronary arteritis and myocarditis. For this, doctors have validated IVIG i.e. Intravenous Immunoglobulin as the first-line treatment to cure acute phase of Kawasaki Disease in most of the prospective levels of multicentre treatment trails.
According to the American Heart Association, patients should undergo treatment by only one IVIG infusion for more than 12hours and the dosage in this case should be 2gram/kg in 10days of the onset of fever. In addition, doctors recommend for anti-inflammatory 100miligram/kg of aspirin dosage to spread out more than 4 doses until and unless the patient becomes afebrile.
Kawasaki Disease Management At Its Chronic Phase
The main objective behind chronic phase management of Kawasaki Disease is to avoid the occlusion of coronary artery and myocardial infarction via reducing the aggregation of platelets and inhibition of thrombogenesis. Long-term treatment options in this case involve anti-platelet aspirin dosages of about 3miligram to 5miligram per kg in a day until and unless you succeed to see normal echocardiograph within only 6weeks to 8weeks.
Patients associated with coronary artery involvement often require antiplatelet aspirin doses on a long-term basis. Besides this, patients suffering from multiple or giant aneurysms require systemic anticoagulation therapy by using low molecular weight of heparin. Heparin treatment is perfect to prevent severe bleeding and hence, it constitutes a viable option among many young patients dealing with coronary artery involvement in its severe form.
Symptoms of Kawasaki Disease
Kawasaki disease symptoms take place in three different phases-
1st Phase i.e. Acute Phase-
- Fever lasting for about 4 to 5 days and temperature higher than 40degree Celsius
- Conjunctivitis type of symptoms without any thick discharge
- Rashes in the body
- Cracked, dry and red lips with an extremely red tongue
- Red skin and swelling on both palms and soles
- Swelling lymph nodes
2nd Phase i.e. Sub-Acute Phase
- Peeling of both hands and feet skin, usually in large sheets
- Joint pain
- Pain in the abdominal area
3rd Phase i.e. Chronic Phase
- Signs and symptoms go away or patients develop complications. (1)
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