Among systemic vasculitis, Kawasaki disease occupies a special place, since it manifests itself in childhood, but has serious consequences in adult life, outwardly looks like measles or scarlet fever, but with & nbsp; This affects the heart and blood vessels. A hereditary predisposition to Kawasaki disease is assumed, but herpes viruses, staphylococci and streptococci often become provoking factors for its development. Timely diagnosed skin rash and properly treated Kawasaki disease will help save the patient from the risk of getting cardiovascular diseases, including a heart attack.
Kawasaki disease is known in the medical world quite recently, and therefore there is little information about it yet. Scientists believe that earlier Kawasaki disease could not be differentiated from measles, rubella, scarlet fever and many other diseases that manifest as a skin rash. And only thanks to modern diagnostic methods it was possible to find out that this is an immunocomplex lesion of the arteries, and inflammation of their walls gives specific manifestations on the skin. At first, it was believed that Kawasaki's disease proceeds easily, patients are only concerned about a rash on the skin. But later it turned out that this disease & nbsp; is one of the most common causes of childhood heart disease. Moreover, more and more doctors associate heart attacks, cardiac ischemia, early atherosclerosis – with childhood Kawasaki disease.
The nature of the manifestation of Kawasaki disease and provoking factors
The essence of Kawasaki disease is damage to the walls of the arteries due to excessive production of circulating immune complexes. These inflammatory processes appear on the skin, cover some internal organs.
Illness Kawasaki develops mainly in children, predisposing factors (against the background of a hereditary predisposition) are referred to as a bacterial or viral infection.
The disease has three stages – acute, subacute and recovery period, and the third stage can last several months and even years. The disease begins with a high temperature, sometimes lasting up to 2 weeks, while the cervical lymph nodes increase, the patient complains of conjunctivitis, dry mouth, cracked lips. On examination, a crimson tongue and enlarged tonsils are noted.
Later, for 5 weeks, rashes appear on the skin in the form of flat, scaly red spots, blisters, inflamed areas, and the skin on the palms and soles becomes dense and painful, which makes it difficult for the patient to move his fingers.
Together with skin manifestations, Kawasaki disease is accompanied by inflammation of the small joints of the hands and feet, abdominal pain, may be complicated by heart damage, aneurysmal expansion of the coronary vessels, which manifests itself 1.5-2 months after the onset of the disease.
Treatment of Kawasaki disease and its prognosis
Inflammatory changes in the vessels are stopped by the introduction of immunoglobulin, in the absence of improvement, the procedure is repeated. Treatment with intravenous immunoglobulin is effective in the first 10 days from the onset of the disease.
Kawasaki disease patients aspirin is prescribed without fail – as a means of reducing the risk of thrombosis and reducing inflammation. If vascular aneurysms are diagnosed, anticoagulants are recommended.
Corticosteroid treatment for Kawasaki disease is not available despite body rash and severe skin manifestations, as this type of therapy increases the risk of coronary thrombosis.
With timely treatment, Kawasaki disease has a favorable prognosis, but after recovery, patients should be constantly monitored by a cardiologist. Approximately one in five patients who have had Kawasaki disease retains changes in the walls of the coronary arteries for life, which significantly increases the risk of developing myocardial infarction, heart failure.
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