What is Kawasaki disease?

Kawasaki disease is an illness that causes swelling in some of the blood vessels in the body. It’s sometimes called “mucocutaneous lymph node syndrome.” The disease usually affects young children, with most cases occurring in kids under 5 years old. Boys are about 1 1/2 times more likely to develop the disease than girls. Although it can affect children of all races, in the United States, it is seen more often in children of Asian American descent, followed by children of African American descent.

Kawasaki disease usually goes away on its own, but without treatment, it can lead to serious problems with the heart and other organs. In some cases, it can affect the coronary arteries, which are the blood vessels that bring oxygen-rich blood to the heart. This can cause dangerous heart issues.

Causes of Kawasaki disease

The exact cause of Kawasaki disease is unknown, but many researchers are working to find out what triggers it. Current studies suggest that it may be linked to a mix of genetic factors and the way a child’s immune system responds to a virus.

Kawasaki disease is not contagious, so it can’t be spread from person to person, and there is no known way to prevent it. To learn more about research on the genetics of Kawasaki disease, you can visit the NIH (National Institutes of Health) website.

Signs and symptoms of Kawasaki disease

• Fever lasting more than five days, which won't go away with Tylenol® or Motrin®
• Redness in both eyes, without pus or discharge
• Red, chapped lips and red, swollen tongue
• Redness, swelling and/or peeling hands or feet
• Red skin rash (including in the groin area)
• Swollen lymph nodes in the neck
• Irritability and/or fussiness

Less common symptoms:

• Abdominal pain
• Joint pain

Testing and diagnosis of Kawasaki disease

There is no single test that can diagnose Kawasaki disease. Doctors make the diagnosis by examining the child, checking for certain symptoms, and ordering tests that support the diagnosis. 

If Kawasaki disease is suspected, the doctor may order blood tests to look for signs of inflammation. They may also recommend heart tests, such as an echocardiogram or an electrocardiogram (EKG) to check if the coronary arteries are enlarged or if there is any damage to the heart. 

Most of the time, a general pediatrician can make the diagnosis, but sometimes a team of specialists — such as infectious disease, rheumatology, and cardiology doctors — may be involved.

Treatment for Kawasaki disease 

To prevent complications, children with Kawasaki disease need to be treated in the hospital with medicines that reduce inflammation. Treatment should begin as soon as possible, ideally within the first 10 days of illness. The main treatments include aspirin and intravenous gamma globulin (IVIG), which is given through a vein. These medicines help bring down the fever, improve symptoms and protect the blood vessels in the heart from damage. Most children respond well to IVIG and recover fully, but a few may need more IVIG or additional treatments like steroids, especially if they are very young or if their first echocardiogram shows signs of inflammation. Children are usually able to go home once their fever is gone and they are feeling better.

Follow-up for Kawasaki disease

Children diagnosed with Kawasaki disease will need regular check-ups with a cardiologist after they leave the hospital. These visits are important to make sure the heart and blood vessels are healthy. During these check-ups, the doctor will do repeat echocardiograms to look for any inflammation or changes in the heart. If your child was treated with additional medicines, like steroids, they may also need to see a rheumatologist. Most children will continue taking a low dose of aspirin for at least six to eight weeks, until the cardiologist confirms that the heart blood vessels are not damaged.

Additional resources

To learn more about Kawasaki disease, explore these resources:

• Kawasaki Disease Foundation
• healthychildren.org