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Kawasaki Disease: Children
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Kawasaki Disease is an illness that involves the skin, mouth, and lymph nodes, and typically affects children who are under the age of 5. The cause of Kawasaki Disease is unknown, but if the symptoms are recognized early, kids with the disease can fully recover within a few days. If it goes untreated, it can lead to serious complications that can involve the heart.
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Kawasaki disease is an acute illness predominantly affecting young children that was first described in 1967 by Dr Kawasaki in Japan. Affected children develop a high fever lasting longer than five days together with redness of the eyes, the inside of the mouth and the lips. There may ... be a skin rash, swollen glands, and redness and swelling of the hands and feet. Children with Kawasaki disease often have joint pains or arthritis and have characteristic miserableness. Later in the illness there may be peeling of the skin around the finger nails or elsewhere on the hands and feet. Some children do not develop all of these typical features and various other rarer symptoms occur in others.
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The first symptom of Kawasaki disease is a fever that's often higher than 104 degrees Fahrenheit (39 degrees Celsius), which is present for at least 5 days. Within a day or 2, conjunctivitis appears in both eyes, causing redness without the discharge usually associated with it. After a few more days, a rash often appears in the trunk region and the genital area. Lips become cracked, red, and dry, and the tongue gets red and swollen like a strawberry, with a white coating and prominent red bumps. The throat may be sore and irritated as well. The palms of the hands and soles of the feet start to look swollen, purple-red, and irritated. About half of infected children will ... have at least one swollen lymph node in the neck.
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Kawasaki disease is an inflammation of the child's blood vessels. The most important blood vessels involved are those of the heart, including the coronary arteries. Kawasaki disease has become the most common cause of heart disease in children born without birth defects. If Kawasaki disease is not recognized and appropriately treated within 10 days, the risk for permanent heart damage increases. Children can die from heart problems during this illness. They can ... die from heart attacks later in childhood or as young adults.
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Although most children who suffer from Kawasaki disease make a full recovery, those who have had injury to their coronary arteries and have developed coronary artery aneurysms may suffer long term consequences of the disease. There is a small risk of narrowing of the coronary arteries developing months or even years after the acute illness, which can result in angina or heart attack. Death occurs in less than two per cent of patients with aneurysms during childhood and adolescence as a result of heart attacks. Most of these heart attacks occur in the first few months. Long term follow up of the severely affected children is often required, and they may be treated with drugs, such as Aspirin, to reduce the risk of clots forming within the damaged coronary arteries. Some authors have suggested that unrecognized Kawasaki disease may account for 1 in 10 of the sudden deaths from heart attacks that occur in young adults.
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Abstract: Kawasaki disease is the leading cause of acquired heart disease in children in developed countries. Most cases are seen in children under 5 years old. It is a generalized vasculitis associated with an intense inflammatory state that can lead to aneurysms of the coronary arteries, complicated sometimes by thrombosis, myocardial infarction and death. The specific etiology remains unknown. There is no specific diagnostic test, but a case definition helps to make the diagnosis. Timely recognition of typical and atypical cases is essential as treatment with large doses of IVIG within the first 10 days of illness greatly reduces risk of coronary artery aneurysms.
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