Your doctor may also refer you to a pediatrician with a specialty in infectious disease, rheumatology, or cardiology. With early treatment, almost all children recover from Kawasaki disease. Without treatment, up to 25 percent of children develop heart problems such as coronary artery aneurysms , which typically begin one to four weeks after the onset of Kawasaki disease. Treatment lowers the risk of heart complications to about 1 in In children who are not treated, the death rate is about 1 percent death almost always occurs in the first six months of life but can happen up to a decade later.
If a child develops aneurysms, they have an increased risk of having heart problems as adults, even if the aneurysms resolve. The standard treatment for Kawasaki disease consists of high doses of both aspirin and immunoglobulin, which is a purified form of proteins and antibodies from donated blood. For one to four days, immunoglobulin is administered intravenously, and aspirin is given orally.
When the child has no fever for four to five days, the dose of aspirin is lowered. But children with Kawasaki disease must continue to take aspirin for at least eight weeks from the onset of the illness. If there are no coronary artery aneurysms and no further signs of inflammation, aspirin may be discontinued. But children with coronary artery abnormalities need long-term treatment with aspirin. Additional treatments may be required if a patient does not respond well to the initial dose of immunoglobulin, their fever comes back, or there are abnormal findings on the first echocardiogram.
In these cases, doctors may recommend another dose of immunoglobulin or other medications that fight inflammation, such as steroids, infliximab , or etanercept. Children with large coronary aneurysms may be given anticoagulants, which are drugs that prevent the blood from clotting. The most serious potential complication of Kawasaki disease is the development of a coronary artery aneurysm, which is a bulge in the wall of the arteries that supply blood to the heart.
Coronary artery aneurysms can rupture or cause a blood clot, leading to a heart attack and sudden death. Hsu, MD , the division chief of pediatric cardiology and the codirector of the pediatric heart center at Children's Hospital at Montefiore in New York City. Portman adds that some children may have problems with their heart for the rest of their lives. Some may need special procedures or surgery to keep the coronary arteries open.
Certain genes may make your child more likely to get Kawasaki disease. Kawasaki disease is a leading cause of acquired heart disease in children. However, with effective treatment, only a few children have lasting damage. Any of these complications can damage your child's heart. Inflammation of the coronary arteries can lead to weakening and bulging of the artery wall aneurysm. Aneurysms increase the risk of blood clots, which could lead to a heart attack or cause life-threatening internal bleeding.
For a very small percentage of children who develop coronary artery problems, Kawasaki disease can cause death, even with treatment. Kawasaki disease care at Mayo Clinic.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Most kids will feel better within a few days of starting treatment. If the condition isn't found until later, patients can have serious complications that affect the heart, such as:.
Doctors don't know what causes Kawasaki disease. They believe it doesn't spread from person to person. It's most common among children of Japanese and Korean descent, but can affect any child. Kawasaki disease symptoms can look similar to those of other childhood viral and bacterial illnesses. Doctors usually diagnose it by asking about the symptoms such as a long-lasting fever and doing an exam. Treatment begins as soon as possible.
In some children, IVIG may not work and doctors give steroids instead. Read more about the possible causes of Kawasaki disease. It's best if treatment begins as soon as possible.
The sooner treatment starts, the quicker the recovery time and there's less risk of complications developing. Intravenous immunoglobulin IVIG , a solution of antibodies, and aspirin are the 2 main medicines used to treat Kawasaki disease. Read more about treating Kawasaki disease. Kawasaki disease causes the blood vessels to become inflamed and swollen, which can lead to complications in the blood vessels that supply blood to the heart coronary arteries. Without treatment, around 1 in 4 children with Kawasaki disease get heart complications.
0コメント