In Kawasaki syndrome, the blood vessels of children between the ages of two and five are inflamed. You can find out what symptoms there are and what helps here.
What is Kawasaki Syndrome?
The so-called Kawasaki syndrome primarily affects children between the ages of two and five. The disease causes inflammation in all blood vessels, and the children feel very sick and suffer from fever and rashes, among other things. If Kawasaki syndrome is left untreated, the coronary arteries are severely damaged in about a third of all cases, causing a heart attack and, in the worst case, death. If the disease is recognized and treated, 99.5 percent of the patients survive.
Especially the small and medium-sized blood vessels are affected by Kawasaki syndrome, but the organs can also be affected. This ensures that the disease can make itself felt in children through many different symptoms that are not always entirely clear. Doctors consider the Kawasaki syndrome to be an inflammation of the blood vessels ("vasculitis"). The disease owes its name to the Japanese Kawasaki, who first described it in 1967. His patients were very ill-looking and feverish children.
How Often Does Kawasaki Syndrome Occur?
In this country around nine out of 10,000 children fall ill with Kawasaki syndrome every year. In Japan, where the syndrome was first described, the incidence rate is about 20 percent higher. The reasons for this are unknown. In general, Kawasaki syndrome affects more boys than girls.
Causes of Kawasaki Syndrome
So far it has not been conclusively clarified what causes Kawasaki syndrome, and clear clinical studies are not available. However, experts assume that an overreaction of the immune system is a possible trigger. This causes changes in the form of inflammation in the blood vessels, which also damage the vessel walls ("aneurysms"). But genetic factors could also play a role – siblings of a sick child are more likely to get sick themselves.
Symptoms of Kawasaki Syndrome
Since the disease can theoretically affect any organ and manifests itself through a variety of complaints, the correct diagnosis is not always easy. However, there are five main symptoms that speak for Kawasaki syndrome. These include:
- Strawberry tongue: Lips, tongue and oral mucosa are bright red in 90 percent of cases. Experts speak of a raspberry or strawberry tongue here.
- Conjunctivitis: Many children suffer from conjunctivitis on both sides, which is noticeable by reddened eyes and red vessels in the whites of the eyes. Important: in Kawasaki syndrome, conjunctivitis is not purulent.
- Fever: For more than five days the children suffer from a fever of at least 39 degrees for which there is no clear cause. The fever cannot be lowered – not even with antibiotics.
- Skin rash: About 80 percent of young patients have a rash that spreads to the abdomen, chest and back and can look different from case to case. The palms of the hands and the soles of the feet can also be covered. About two to three weeks later, the skin on the fingers and toes flakes off.
- Swollen lymph nodes: In two thirds of all cases in the affected children, the lymph nodes on the neck are swollen. Generally speaking, this is a body reaction that shows that the immune system is fighting an inflammatory reaction.
In general, the children are limp and tired and feel very sick. Some people who have Kawasaki syndrome also experience rather rare symptoms such as
Kawasaki syndrome: treatment
The Kawasaki syndrome is primarily treated with antibodies ("immunoglobulins"). These artificially produced proteins not only inhibit inflammation, but also help the immune system. The sooner the therapy is started, the better – this largely avoids vascular damage to the heart and the possible complications that may result from it. Acetylsalicylic acid is said to lower the fever and prevent blood clotting in order to further reduce the risk of heart attacks.
If coronary arteries have been damaged (in rare cases), an intervention may be necessary to ensure the blood supply to the heart. A stent, for example, can be used for this – small mesh tubes that are inserted into the artery and support it from the inside. After the end of treatment, the heart must also be examined for possible damage in any case, even if the disease was comparatively mild.
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Bieber, C. et al .: Dual Series of Internal Medicine, Georg Thieme Verlag, 3rd edition, 2013
Pieper, W .: Internal Medicine, Springer Verlag, 2nd edition, 2013
Guideline of the Society for Child and Adolescent Rheumatology and the German Society for Parametric Cardiology and Congenital Heart Defects