Health Article
Jan 19, 2021

Kawasaki Disease

Kawasaki disease is discovered by Dr. Tomisaku Kawasaki in Japan in 1967 and then known as mucocutaneous lymph node syndrome.  In honor of its discoverer, it is called Kawasaki Disease (PK= Penyakit Kawasaki).  In Indonesia, many of us do not understand this dangerous disease, even in the medical community.  This is why the diagnosis is often late with all the consequences.

The appearance of this disease can also trick the eye into being diagnosed with measles, a drug allergy, viral infection or even mumps.  The disease, which is more common in Mongol races, mainly affects toddlers and is most common in children aged 1-2 years.  Boys are affected more than girls, the reasons for this are not clear.

Kawasaki disease is a rare disease due to inflammation of the blood vessels throughout the body.  The symptoms are fever for several days, rash / red spot, swelling of hands and feet, red eyes, irritation and inflammation of the mucous membranes of the mouth, lips and throat and swollen lymph nodes in the neck.  The short-term effects may not be serious, but in some cases, long-term complications including coronary artery damage can occur.

The cause of Kawasaki disease is unknown.  Many researchers think it may be due to a viral or bacterial infection.  There is a tendency toward hereditary / hereditary factors, so for example it is more often found in Japanese descent.  There is currently no evidence that this disease is contagious.

The initial symptom in the acute phase is a sudden high fever that can reach 39 – 41C, fluctuating for at least 5 days.  In untreated children, fever can last for 1-4 weeks continuously.  Antibiotics do not help.

About 2-3 days after fever, other symptoms appear gradually, such as red spots on the body that are similar to measles.  Often they are bright red in color, can be well-defined of various sizes or several rashes converge to become large.  Another symptom is inflammation in both eyes (red eyes) usually without dirt, swollen lymph nodes on one side of the neck so that it is sometimes mistaken for mumps (parotitis), red tongue and rash, known as strawberry tongue, dry lips or cracked on lips, often red in color, the mucous membrane of the mouth becomes redder.  The palms and feet become red, sometimes they got swollen and also the joint pains.

After the fever subsides, the rash, red eyes and enlarged lymph nodes also disappear.  The skin begins to peel around the fingers and toes, usually in the third week, it can be in large pieces or as a single one.  The knees, hips, and ankles become more inflamed and painful, which sometimes persists even though other symptoms have disappeared.  In the healing phase, transverse lines appear on the toenails and fingers which can last for several months until the nails are gone (Beau line).

The treatment of choice for Kawasaki disease is the administration of intravenous immunoglobulins, which are effective in reducing inflammation and reducing the risk of heart damage if given within the first 10 days of illness.  Also given high doses of aspirin in the early acute phase until the fever subsides.  If the examination finds an aneurysm (widening of the heart blood vessel segment) or other heart / blood vessel abnormalities, medical or surgical treatment may be necessary.  The doctor will have a cardiologist monitor for several years after the Kawasaki disease is cured.

The most dreaded complication in Kawasaki disease is the heart because it can damage the heart arteries.  Complications to the heart usually start after 7-8 days since the onset of fever.

The first and only Indonesian Kawasaki Patient Parents Association (POPKI = Perkumpulan Orang Tua Penderita Kawasaki Indonesia) was officially established in Indonesia on July 26th 2008.  POPKI was directly coached by an Indonesian expert of Kawasaki disease, Dr. Najib Advani Sp.A (K), MMed, Paed and POPKI themselves were chaired by Mrs. Soeyanny A. Tjahja (Mrs. Aui).  POPKI or Kawasaki Center is on the 3rd floor of Omni International Hospital Alam Sutera, Serpong, Tangerang Selatan.

If a child has symptoms that are similar to those described above, immediately take them to the doctor for further treatment, because late treatment will increase the risk of complications from Kawasaki disease.  To find out more about Kawasaki disease, directly contact the OMNI Hospital at Alam Sutera.