In this section
Kawasaki disease is an uncommon illness that mostly affects
children under five years of age.
It is caused by inflammation of blood vessels throughout the
body, including those of the heart (the coronary vessels). This
inflammation is known as vasculitis. There have been many theories
about what causes this, but no single theory is
generally accepted as being correct. It is thought that an infection of some sort
causes Kawasaki disease, although this has not been proven. Kawasaki disease
is not contagious to other children.
There is no simple test for Kawasaki disease. The diagnosis is
made by recognising the symptoms and signs of Kawasaki disease in a
child who has a persistent fever with no other likely
explanation. Blood tests may be helpful. An echocardiogram
(ultrasound of the heart) is performed to look for any changes
in the coronary (heart) arteries. This is a safe and
painless test; it is similar to the ultrasound examination that is
used to look at the baby when a woman is pregnant.
The disease usually begins with a high fever (over 39ºC) which continues for at least five
Many, but not all, children also develop other symptoms such
Other diseases can be confused with Kawasaki disease. They may
require different treatment.
The most important part of Kawasaki disease is that it may cause
inflammation of the arteries that supply blood to the heart, which
can result in an aneurysm (an air bubble in the artery) that can
cause heart problems in the future. This occurs in about 25 per
cent of patients if they do not receive treatment.
The treatment for Kawasaki disease is intravenous (into a vein
through a drip, also called IV) gammaglobulin. This is made
from donated blood transfusions and contains concentrated amounts
Large doses of intravenous gammaglobulin are usually effective
in stopping the fever and other symptoms of Kawasaki disease, and
seem to help prevent coronary artery problems as well.
Some parents worry about their child being given blood products.
It is important to understand that the risks of this are very low,
yet the risks from untreated Kawasaki disease are quite high.
Most children will also be given aspirin for a few weeks after
the onset of Kawasaki disease. Aspirin helps to prevent problems with
the coronary arteries.
Your child may have to stay in hospital for a few days until the
illness begins to settle. Once you go home, it may take three
or four weeks for your child to be fully back to normal. Don't
be alarmed if your child gets some peeling of the skin on the
hands, feet or groin area - this is very common in the second week
of the illness.
A small number of children develop problems with either the
heart muscle or the coronary arteries. The heart problems appear in
the first phase of the illness and this is why the initial
echocardiogram is performed. If the test is negative it is
very unlikely that problems will develop later, but a further test is usually done after about six to eight weeks.
A small percentage of children will have a recurrence of the symptoms
weeks or months later. If this happens, consult your child's paediatrician.
If your child has Kawasaki disease they will need to be
followed up long-term by their GP (family
doctor) and a paediatrician.
If your child is due a routine MMR (measles, mumps,
rubella) immunisation, this should be delayed until 11 months after the gammaglobulin treatment.
The vast majority of children with Kawasaki disease recover and
live normal lives.
Developd by The Royal Children's Hospital General Medicine.
Reviewed: May 2011