How Is Kawasaki Disease Treated?
Kawasaki disease is mainly treated with medicines.
Rarely, medical procedures and surgery may be used for children whose coronary
arteries are affected.
The goals of treatment are to:
- Lower fever and reduce inflammation to improve
symptoms
- Prevent the disease from affecting the coronary
arteries
Initial Treatment
Kawasaki disease can cause serious complications.
Therefore, your child will likely be treated in a hospital, at least for the
early part of the treatment.
The standard treatment during the disease's acute
phase is high-dose aspirin and immune globulin. Immune globulin is a medicine
given intravenously (injected into a vein).
Most children who receive these treatments improve
greatly within 24 hours. For a small number of children, fever remains. In
these cases, a second round of immune globulin may be given.
At the start of treatment, high doses of aspirin are
given. As soon as your child's fever goes away, a low dose of aspirin is given.
The low dose helps prevent blood clots, which can form in the inflamed small
arteries.
Most children treated for Kawasaki disease fully
recover from the acute phase and don't need any further treatment. They should,
however, follow a healthy diet and adopt healthy lifestyle habits to lower
their risk for future heart disease (this is advised for all children, not just
those who have the disease).
Children who have had immune globulin should wait 11
months before having the measles and chicken pox vaccines. Immune globulin can
prevent those vaccines from working properly.
Long-Term Care and Treatment
If Kawasaki disease has affected your child's
coronary arteries, he or she will need ongoing care and treatment. It's best if
a pediatric cardiologist provides this care to reduce the risk of severe heart
problems. A pediatric cardiologist is a doctor who treats children who have
heart problems.
Medicines and Tests
When Kawasaki disease affects the coronary arteries,
they may expand and twist. If this happens, your child's doctor may prescribe
anticoagulants (like warfarin) to prevent blood clots from forming in the
affected coronary arteries.
Anticoagulants usually are stopped after the
coronary arteries heal. Healing may occur about 18 months after the acute phase
of the disease.
For the small number of children whose coronary
arteries don't heal, routine tests are needed. These include:
- Echocardiography.
This test uses sound waves to create images of the heart.
- EKG
(electrocardiogram). This test detects and records the heart's electrical
activity.
- Stress
test. This test gives the doctor information about how the heart works
during physical activity or stress.
Medical Procedures and Surgery
Rarely, a child may need
cardiac
catheterization (KATH-e-ter-i-ZA-shun). This procedure is used to diagnose
and treat some heart conditions. A long, thin, flexible tube called a catheter
is put into a blood vessel in the arm, groin (upper thigh), or neck and
threaded to the heart. Through the catheter, doctors can perform diagnostic
tests and treatments on the heart.
Very rarely, a child may need to have other
procedures, or even surgery, if inflammation narrows his or her coronary
arteries and blocks blood flow to the heart.
Coronary
angioplasty (AN-jee-oh-plas-tee),
stent
placement, or
coronary
artery bypass grafting (CABG) may be used.
Coronary angioplasty restores blood flow through a
narrowed or blocked coronary artery. A thin tube with a balloon on the end is
threaded through a blood vessel in the arm or groin (upper thigh) to the
narrowed or blocked coronary artery. The balloon is then inflated to widen the
artery and restore blood flow.
A stent may be placed in the coronary artery during
angioplasty. Stents are small mesh tubes. They're used to keep narrowed or
weakened arteries open. Stents can help improve blood flow and prevent the
artery from bursting.
Rarely, a child may need to have CABG. This surgery
is used when a coronary artery is severely blocked. During CABG, a healthy
artery or vein from another part of the body is connected, or grafted, to the
blocked coronary artery. The grafted artery or vein bypasses (that is, it goes
around) the blocked part of the coronary artery. This improves blood flow to
the heart. |