To reduce the risk of complications, your child's doctor will want to begin treatment for Kawasaki disease as soon as possible after the appearance of signs and symptoms, preferably while your child still has a fever. The goals of initial treatment are to lower fever and inflammation and prevent heart damage.
To accomplish those goals, your child's doctor may recommend:
- Gamma globulin. Infusion of an immune protein (gamma globulin) through a vein (intravenously) can lower the risk of coronary artery problems.
- Aspirin. High doses of aspirin may help treat inflammation. Aspirin can also decrease pain and joint inflammation, as well as reduce the fever. Kawasaki treatment is a rare exception to the rule against aspirin use in children.
Because of the risk of serious complications, initial treatment for Kawasaki disease usually is given in a hospital.
After the initial treatment
Once the fever goes down, your child may need to take low-dose aspirin for at least six weeks and longer if he or she develops a coronary artery aneurysm. Aspirin helps prevent clotting.
However, if your child develops flu or chickenpox during treatment, he or she may need to stop taking aspirin. Taking aspirin has been linked to Reye's syndrome, a rare but serious illness that can affect the blood, liver, and brain of children and teenagers after a viral infection.
Without treatment, Kawasaki disease lasts an average of 12 days, though heart complications may be evident later and be longer lasting. With treatment, your child may start to improve soon after the first gamma globulin treatment.
Monitoring heart problems
If your child has any indication of heart problems, the doctor may recommend follow-up tests to monitor heart health at regular intervals, often at six to eight weeks after the illness began. If your child develops continuing heart problems, the doctor may refer you to a doctor who specializes in treating heart disease in children (pediatric cardiologist). In some cases, a child with a coronary artery aneurysm may require:
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- Anticoagulant drugs. These medications — such as aspirin, clopidogrel (Plavix), warfarin (Coumadin) and heparin — help prevent clots from forming.
- Coronary artery angioplasty. This procedure opens arteries that have narrowed to the point that they impede blood flow to the heart.
- Stent placement. This procedure involves implanting a device in the clogged artery to help prop it open and decrease the chance of reblockage. Stent placement may accompany angioplasty.
- Coronary artery bypass graft. This operation involves rerouting the blood around a diseased coronary artery by grafting a section of blood vessel from the leg, chest or arm to use as the alternate route.
- Kawasaki disease. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/pediatrics/miscellaneous_disorders_in_infants_and_children/kawasaki_disease.html. Accessed Aug. 19, 2013.
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed Aug. 192013.
- Scuccimarri R. Kawasaki disease. Pediatric Clinics of North America. 2012;59:425.
- Ayusawa M, et al. Revision of diagnostic guidelines for Kawasaki disease (the 5th revised edition). Pediatrics International. 2005;47:232.
- Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: A statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004;110:2747.
- Sundel R. Initial treatment and prognosis of Kawasaki disease. http://www.uptodate.com/home. Accessed Aug. 19, 2013.
- Taggart NW (expert opinion). Mayo Clinic, Rochester, Minn. Sep. 9, 2013.