Is it Kawasaki disease?

Kawasaki disease was discovered by Dr. Tomisaku Kawasaki in Japan in 1967 and was then known as mucocutaneous lymphnode syndrome. In honor of its discoverer, so-called Kawasaki disease. Many of us who do not understand this dangerous disease, even in medical circles though. This is why the diagnosis is often late with all the consequences.

The appearance of this disease also can fool the eye so that it can diagnosed as measles, allergy medicines, viral infections, or even the mumps disease. The disease is more frequently attacked the Mongol race was mainly attacked children and most often in children aged 1-2 years. In fact, the author never found a Kawasaki disease at a 3-month-old baby who suffered from fever for 18 days.

The incidence per year in Japan the highest in the world, namely around 1 case per 1,000 children under five, followed by Korea and Taiwan. In the United States range from 0.09 (at the white race) to 0.32 (in the Asian-Pacific) per thousand children under five. The authors find the case of Kawasaki disease since 1996, but there are doctors who declared already found previously.

Early symptoms Kawasaki disease

The initial symptoms in the acute phase is a sudden high fever and can reach 41 ° C. Fluctuating fever for at least 5 days but never reached normal. In untreated children, fever can last for 1-4 weeks without a break. Antibiotics do not help. Approximately 2-3 days after fever, other symptoms began to appear gradually are patches of red spots on the body much like the measles.

However, cough and cold symptoms are dominant in measles is usually mild or nonexistent in the PK. Other symptoms that arise are the two red eyes, but without the dirt (belekan), swollen lymph nodes on one side of the neck so that the disease is sometimes suspected mumps (parotitis), resembles a strawberry red tongue, lips red as well and sometimes cracked, palm of hand and legs red and slightly swollen. Sometimes a child complains of pain in the joints. In the healing phase exfoliation occurred at the fingertips of the hands and feet and then arise transverse-shaped basin at the foot and hand nails (Beau's lines).

PK Patients must be hospitalized in the hospital and receive supervision from the child's cardiologist. The most feared complication is in the heart (occurs in 20-40 percent of patients) because it can damage the coronary arteries. Complications to the heart usually starts happening after a day to 7-8 since the inception of a fever.

At the beginning of this vessel dilation may occur later can occur narrowing or blockage of the inside. As a result blood flow to the heart muscle disturbed so that it can cause damage to the heart muscle, known as myocardial infarction. Examination of the heart becomes very important, including ECG and echocardiography (cardiac ultrasound). Sometimes ultrafast CT scan, MRA (Magnetic Resonance Angiography) and cardiac catheterization is required in severe cases. Laboratory tests for this disease there is no typical.

Usually the white blood cell count, erythrocyte sedimentation rate and C reactive protein is increased in acute phase. So the diagnosis is established on the basis of clinical symptoms and signs alone so that the doctor's experience is needed. In the healing phase, increased blood platelets, and this will facilitate the occurrence of thrombus, or blood clots that clog coronary arteries of the heart.

Treatment of Kawasaki Disease

Drugs are an absolute must given immunoglobulin intravenously for 10-12 hours. Drug plasma obtained from blood donors is effective to relieve symptoms and reduce the risk of PK heart damage, but an expensive price to be constraints. The price of a gram of around Rp 1 million. PK Patients require immunoglobulin 2 g per kg of body weight.

For example, children whose weight is 15 kg for example, requires 30 grams or costing about USD 30 million. Patients are also given salicylic acid to prevent heart damage and coronary artery blockage. If there are no complications the child can return home within a few days. In the case of a late and already there is damage to the coronary vessels have a longer hospitalization and intensive treatment to prevent further heart damage.

If the drugs do not work, sometimes required coronary bypass surgery (coronary bypass) or even, though very rarely, a heart transplant. Death can occur in 1-5 percent of patients who are generally too late to treat and the peak occurred at 15-45 days after the initial onset of fever. Nevertheless, sudden death may occur many years after the acute phase. PK also can damage the heart valves (especially mitral valve) that can cause sudden death a few years later. The possibility of a recurrence of this disease is about 3 percent.

In patients who had clinically fully recovered though, is said to have coronary artery abnormalities in the inner layer that facilitates the occurrence of coronary heart disease in later young adulthood. If found in acute coronary heart attacks in young adults, may need to consider the possibility of never exposed to PK while still a child. Presumably we all need to be aware of this disease to avoid further casualties.