Kawasaki disease

Kawasaki disease usually has to be treated in hospital as it can cause serious complications. It is best for your child to receive treatment as soon as possible, ideally within 10 days of their symptoms first starting.

If your child's condition is not treated promptly, it may take longer for them to recover and they are at greater risk of developing complications.

There are two main medicines used to treat Kawasaki disease:

• aspirin
• intravenous immunoglobulin

These are described in more detail below.

Aspirin

If your child has Kawasaki disease, they may be prescribed aspirin. This is one of the few occasions when a child who is under 16 years of age will be given aspirin. Unless it is prescribed by a healthcare professional treating your child, never give your child aspirin.

Aspirin is a non-steroidal anti-inflammatory drug (NSAID). It is used to treat Kawasaki disease because:

• aspirin can ease pain and discomfort
• aspirin can reduce a high temperature (fever)
• at high doses, aspirin is an anti-inflammatory (it reduces swelling)
• at low doses, aspirin is an antiplatelet (it prevents blood clots from forming)

Initially, your child may be given a high dose of aspirin, which will then be changed to a low dose. The dose that your child is prescribed and how long they need to take it for will depend on your child’s symptoms.

In general, your child may be prescribed a high dose of aspirin until they no longer have a fever. After this, they may be prescribed a low dose of aspirin until six to eight weeks after the start of their symptoms. This is to prevent coronary artery abnormalities (problems developing in the blood vessels that supply blood to the heart).

A review into using aspirin to treat Kawasaki disease did not find any evidence either for or against its use. In theory, aspirin should prevent heart complications because it works as an anti-inflammatory and an antiplatelet. Aspirin is likely to continue to be used to treat Kawasaki disease, although further research is needed. 

Intravenous immunoglobulin

Intravenous immunoglobulin is also called IVIG. Immunoglobulin is a solution of antibodies (proteins produced by the immune system to fight disease-carrying organisms) that is obtained from healthy donors. Intravenous means that is injected into a vein.

The immunoglobulin used to treat Kawasaki disease is also called a gamma globulin.
 
After you child receives IVIG, their symptoms will usually improve within 36 hours. Research has shown that IVIG can reduce your child’s fever and reduce the risk of heart problems. If their fever does not disappear after 36 hours, your child may be given a second dose of IVIG.

Possible treatment

Corticosteroids (steroids) are a type of medication that contains hormones (powerful chemicals that have a wide range of effects on the body). They are currently being researched to see if they are beneficial in treating Kawasaki disease.

One review of research into corticosteroids found that they can reduce the need to be treated again with IVIG, but do not reduce the risk of heart problems. While further research is underway, corticosteroids may be used if a second dose of IVIG does not work.

After treatment

When your child is discharged from hospital, you should be given instructions for how to care for them at home. This could include making sure that your child is as comfortable as possible and that they get plenty of fluids. 

Make sure that your child continues to take any medication they have been prescribed as instructed and watch out for any side effects.

You will be given a follow-up appointment and your child’s heart will continue to be monitored. Once an echocardiogram (an ultrasound scan of the heart) has confirmed that your child does not have any heart abnormalities, they can usually stop taking aspirin.

Some symptoms, such as peeling skin, may not occur until three to four weeks after the start of the condition and a full recovery could take around six weeks (see Symptoms of Kawasaki disease). 

Glossary

Disease
A disease is an illness or condition that interferes with normal body functions.

Fever
A fever is when you have a high body temperature of 38C (100.4F) or over.

Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.

Platelet
Platelets are cells in the blood that control bleeding by plugging the broken blood vessel and helping the blood to clot.

Heart
The heart is a muscular organ that pumps blood around the body.

Blood vessel
Blood vessels are the tubes in which blood travels to and from parts of the body. The three main types of blood vessels are veins, arteries and capillaries.

Antibodies
Antibodies are your body's natural defence against any foreign antigens that enter your blood. An antibody is a protein that is produced by the body to neutralise or destroy disease-carrying organisms and toxins.

Immune system
The immune system is the body's defence system, which helps protect it from disease, bacteria and viruses.

Hormones
Hormones are groups of powerful chemicals that are produced by the body and have a wide range of effects.