Burns cause "legendary" diseases, not uncommon in Kawasaki

Author: Zhang Xin, Chief Physician, Beijing Children's Hospital, Capital Medical University

Reviewer: Wang Fangyun, Chief Physician, Beijing Children's Hospital, Capital Medical University

In the vast field of pediatric medicine, there are many unknown "legendary" diseases. They challenge the wisdom and courage of doctors and parents with their unique symptoms, complex pathological mechanisms and potential serious consequences. Kawasaki disease is one of these "legends". This name may sound a little unfamiliar, but it is actually a complex and important pediatric autoimmune disease, the full name of which is mucocutaneous lymph node syndrome. It is like a sudden heat wave, testing the patience and courage of the families of children with the disease, and also testing the wisdom and determination of doctors.

1. What is Kawasaki disease?

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is an autoimmune disease with systemic vasculitis as the main symptom. It mainly affects infants under 5 years old, but older children and adults may also develop the disease, but it is relatively rare. The pathogenesis of this disease has not yet been fully understood, but it is generally believed to be related to immune abnormalities caused by infection with viruses, bacteria or other pathogens. Kawasaki disease is like an "invisible killer" hidden behind children's health, which needs to be taken seriously by parents and doctors.

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2. What are the main manifestations of Kawasaki disease?

The symptoms of Kawasaki disease are diverse and complex, causing considerable distress to children and their families. First of all, the most significant symptom is persistent high fever, which usually lasts for more than 5 days and is ineffective against conventional anti-infection treatment. In addition, the skin and mucous membranes may also be affected, such as red eyes, red and cracked lips, bayberry-like tongue, rash, etc. Some children may also experience swelling of the hands and feet or peeling of the fingertips (toes) of the hands and feet, as well as enlarged lymph nodes in the neck. What is more serious is that some children may also experience systemic symptoms such as drowsiness, abdominal pain, diarrhea, vomiting, and joint pain. The appearance of these symptoms further increases the difficulty of diagnosis and the complexity of treatment.

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3. What are the common heart diseases in Kawasaki disease?

Kawasaki disease is particularly harmful to the heart, and the most characteristic cardiac lesion is the dilation of the coronary arteries, which may even form coronary artery aneurysms. These lesions not only affect the normal function of the heart, but may also cause a series of serious complications, such as myocardial infarction and heart failure. In addition, Kawasaki disease may also lead to heart diseases such as myocarditis, pericarditis, and endocarditis, which manifest as symptoms such as heart enlargement, decreased myocardial contractility, pericardial effusion, and valvular insufficiency. Therefore, timely cardiac evaluation and intervention are crucial for children with Kawasaki disease.

4. The child has symptoms such as fever and rash, but there is no dilation of the coronary arteries. Can Kawasaki disease be ruled out?

Although coronary artery dilatation is one of the characteristic manifestations of Kawasaki disease, not all children will have this abnormality. In fact, among children with Kawasaki disease, only about 30% will experience coronary artery dilatation, while the diameter of the coronary arteries in the remaining 70% of children may remain normal. Therefore, it is inaccurate to judge whether a person has Kawasaki disease based solely on whether the coronary arteries are dilated. Doctors need to comprehensively consider the child's medical history, clinical manifestations, and various test results to make a diagnosis. If a child has typical symptoms of Kawasaki disease such as persistent high fever and rash, the possibility of Kawasaki disease cannot be easily ruled out even if the coronary arteries are not dilated.

5. Does the discovery of coronary artery dilatation necessarily mean Kawasaki disease?

Coronary artery dilatation is not an exclusive symptom of Kawasaki disease. It may be caused by a variety of reasons, including congenital vascular abnormalities and the effects of acquired factors on blood vessels. Therefore, the discovery of coronary artery dilatation cannot be directly diagnosed as Kawasaki disease. Doctors need to carefully inquire about the child's medical history, complete relevant examinations, and combine other clinical manifestations and examination results to make a correct diagnosis. At the same time, for children who have been diagnosed with Kawasaki disease, it is also necessary to closely monitor changes in their coronary arteries in order to promptly detect and deal with other possible complications.