By Beatriz Ara˙jo de Freitas
From Medstudents Homepage

Kawasaki disease is a febrile condition affecting primarily children who are 5 years of age or younger. It is notable for its association with vasculitis of the large coronary blood vessels. It has surpassed rheumatic fever as the leading cause of acquired heart disease in children in the United States, has been recognized worldwide, and appears to be increasing in frequency. Kawasaki disease has been described in all racial groups, but appears to be a predilection for Japanese.

There is no evidence for person-to-person transmission. The cause remains unknown, but bacterial toxins similar the staphylococcal toxins of the toxic shock syndrome may be involved in its pathogenesis. There is no evidence that autoimmunity plays a role in pathogenesis; the finding of increased members of T-cell subset is consistent with toxin superantigen stimulation.


Diagnostic rests on the demonstration of characteristic clinical signs:

A. Fever lasting for at least 5 days unresponsive to antibiotic therapy.
B. Presence of four of the following conditions:
    1. Bilateral nonpurulente conjunctival injection.
    2. Changes of the mucosa of the oropharynx, including infected pharynx, infected and/or dry fissured lips, strawberry tongue.
    3. Changes of the peripheral extremities, such as edema and/or erythema of the hands or feet, desquamation, usually beginning periungually.
    4. Rash, primarily truncal, polymorphous but nonvesicular.
    5. Cervical lymphadenopathy.

C. Illness not explained by other known disease process.

The disease can be subdivided into four stages:

1. Acute Phase:
  • Lasts about 10 days.
  • Fever, conjunctivitis, oral changes, extremity changes, irritability, rash, cervical lymphadenopathy, high erythrocytes sedimentation rate.
  • Aseptic meningitis frequently is found.
  • Myocarditis and pericarditis may occur.
2. Subacute Phase:
  • Lasts from days 11 through 21.
  • Usually associated with a decrease in fever.
  • Irritability persists.
  • Normalization of most clinical findings.
  • Palpable aneurysms may develop.
3. Convalescent Phase:
  • Lasts from days 21 through 60.
  • Most clinical findings resolve.
  • Aneurysmal dilatation of peripheral vessels may persist.
  • Conjunctivitis may persist.
  • Myocardial infarctions and rupture of aneurysms may occur.
4. Chronic Phase:
  • After day 60.
  • Angina pectoris, coronary stenosis, or myocardial insufficiency may develop.
Atypical cases manifesting few early signs but later caricaturists coronary artery lesions have been reported. Atypical patients, often younger than 1 year of age, may have incorrect admitting diagnoses [gastroenteritis, viral syndrome, sepses], and a high morbidity rate.


There are no diagnostic tests. Leukocytosis with a predominance of immature forms and thrombocytosis [in the 2nd-3rd week] can be streaking; anemia is also common. Sedimentation rates and C-reactive proteins levels are usually greatly elevated. Test results for autoantibodies including ANA and rheumatoid factors are negative, and hemolytic complement levels are normal or high. Mild proteinuria and pyuria may be present, as may cerebrospinal fluid pleocytosis. Serum levels of hepatic transaminases and bilirubin may be slightly elevated.

Cardiac involvement is the most important manifestation of the disease. Two-dimensional echocardiogram should be performed in all children with known or suspected Kawasaki disease at the time of presentation and again during the first 2 weeks of disease.


Diagnosis rests on the clinical features. There are no diagnostic laboratory tests, although demonstration of coronary artery involvement revealed by echocardiogram is highly suggestive of this condition. The differential diagnoses includes scarlet fever, toxic shock syndrome, leptospirosis, Epstein-Barr virus infection, juvenile rheumatoid arthritis, measles, acrodynia, Rocky Mountain spotted fever, drug reactions, Stevens-Johnson syndrome, and vasculitis syndromes.


Recovery is usually complete in patients who do not have detectable coronary vasculitis; second attacks occur only rarely. A few reports detail the later occurrence of aneurysms of large vessels than the coronary arteries.

Duration of fever, presumably reflecting the severity of ongoing vasculitis, has been confirmed as a powerful predictor of these lesions.


Kawasaki disease responds dramatically to therapy with intravenous gamma globulin given during the period of active febrile disease. Fever and other attendant systemic manifestations often abate within 24 hours of initial therapy. Furthermore, controlled studies show that intravenous gamma globulin therapy given early in disease prevents coronary vascular involvement. The recommended regimen consists of an intravenous infusion of 2 g/kg given as a single dose over 10-12 hours. Therapy given within 10 days of onset appears to be effective in preventing coronary vascular damage. Side effects of intravenous gamma globulin therapy are rare and include anaphylaxis, chills, fever, headache, and myalgia.

Salicylate therapy is also indicated during the febrile phase; therapeutic serum concentrations of 20 to 30 mg/dl are desirable but may be difficult to achieve, even with doses of salicylates as high as 100 mg/kg/24 hours. Continuance of low, single-dose [5 mg/kg/24 hours] salicylate therapy for its antithrombotic effects has been advocated for 6 to 8 weeks after the period of active disease subsides. Low-dose aspirin with or without dipyridamole should be continued until coronary lesions resolve.

Corticosteroids therapy is rarely used in Kawasaki disease, and some consider it contraindicated.

Thrombolytic therapy with agents such as streptokinase has been used for patients with thrombosis or peripheral artery ischemia. Arterial bypass surgery may be appropriate for rare patients with severe coronary occlusion.


1. Nelson: Textbook of Pediatrics

2. Peter C. Rowe, Angela Quinlan and Brian K. H. Luke: Value of degenerative change in neutrophils as a diagnostic test for Kawasaki disease: J PEDIATR 1991: vol 119:370-374

3. Robert P. Sundel, Jane C. Burns, Annette Baker, Alexa Beiser and Jane W. Newburger: Gamma globulin re-treatment in Kawasaki disease: J PEDIAT 1993.vol 123:657-659

MoonDragon's Articles Index

MoonDragon's Womens Health Index

| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z |

Health & Wellness Index


Allspice Leaf Oil
Angelica Oil
Anise Oil
Baobab Oil
Basil Oil
Bay Laurel Oil
Bay Oil
Benzoin Oil
Bergamot Oil
Black Pepper Oil
Chamomile (German) Oil
Cajuput Oil
Calamus Oil
Camphor (White) Oil
Caraway Oil
Cardamom Oil
Carrot Seed Oil
Catnip Oil
Cedarwood Oil
Chamomile Oil
Cinnamon Oil
Citronella Oil
Clary-Sage Oil
Clove Oil
Coriander Oil
Cypress Oil
Dill Oil
Eucalyptus Oil
Fennel Oil
Fir Needle Oil
Frankincense Oil
Geranium Oil
German Chamomile Oil
Ginger Oil
Grapefruit Oil
Helichrysum Oil
Hyssop Oil
Iris-Root Oil
Jasmine Oil
Juniper Oil
Labdanum Oil
Lavender Oil
Lemon-Balm Oil
Lemongrass Oil
Lemon Oil
Lime Oil
Longleaf-Pine Oil
Mandarin Oil
Marjoram Oil
Mimosa Oil
Myrrh Oil
Myrtle Oil
Neroli Oil
Niaouli Oil
Nutmeg Oil
Orange Oil
Oregano Oil
Palmarosa Oil
Patchouli Oil
Peppermint Oil
Peru-Balsam Oil
Petitgrain Oil
Pine-Long Leaf Oil
Pine-Needle Oil
Pine-Swiss Oil
Rosemary Oil
Rose Oil
Rosewood Oil
Sage Oil
Sandalwood Oil
Savory Oil
Spearmint Oil
Spikenard Oil
Swiss-Pine Oil
Tangerine Oil
Tea-Tree Oil
Thyme Oil
Vanilla Oil
Verbena Oil
Vetiver Oil
Violet Oil
White-Camphor Oil
Yarrow Oil
Ylang-Ylang Oil
Healing Baths For Colds
Herbal Cleansers
Using Essential Oils


Almond, Sweet Oil
Apricot Kernel Oil
Argan Oil
Arnica Oil
Avocado Oil
Baobab Oil
Black Cumin Oil
Black Currant Oil
Black Seed Oil
Borage Seed Oil
Calendula Oil
Camelina Oil
Castor Oil
Coconut Oil
Comfrey Oil
Evening Primrose Oil
Flaxseed Oil
Grapeseed Oil
Hazelnut Oil
Hemp Seed Oil
Jojoba Oil
Kukui Nut Oil
Macadamia Nut Oil
Meadowfoam Seed Oil
Mullein Oil
Neem Oil
Olive Oil
Palm Oil
Plantain Oil
Plum Kernel Oil
Poke Root Oil
Pomegranate Seed Oil
Pumpkin Seed Oil
Rosehip Seed Oil
Safflower Oil
Sea Buckthorn Oil
Sesame Seed Oil
Shea Nut Oil
Soybean Oil
St. Johns Wort Oil
Sunflower Oil
Tamanu Oil
Vitamin E Oil
Wheat Germ Oil


  • MoonDragon's Nutrition Basics Index
  • MoonDragon's Nutrition Basics: Amino Acids Index
  • MoonDragon's Nutrition Basics: Antioxidants Index
  • MoonDragon's Nutrition Basics: Enzymes Information
  • MoonDragon's Nutrition Basics: Herbs Index
  • MoonDragon's Nutrition Basics: Homeopathics Index
  • MoonDragon's Nutrition Basics: Hydrosols Index
  • MoonDragon's Nutrition Basics: Minerals Index
  • MoonDragon's Nutrition Basics: Mineral Introduction
  • MoonDragon's Nutrition Basics: Dietary & Cosmetic Supplements Index
  • MoonDragon's Nutrition Basics: Dietary Supplements Introduction
  • MoonDragon's Nutrition Basics: Specialty Supplements
  • MoonDragon's Nutrition Basics: Vitamins Index
  • MoonDragon's Nutrition Basics: Vitamins Introduction


  • MoonDragon's Nutrition Basics: 4 Basic Nutrients
  • MoonDragon's Nutrition Basics: Avoid Foods That Contain Additives & Artificial Ingredients
  • MoonDragon's Nutrition Basics: Is Aspartame A Safe Sugar Substitute?
  • MoonDragon's Nutrition Basics: Guidelines For Selecting & Preparing Foods
  • MoonDragon's Nutrition Basics: Foods That Destroy
  • MoonDragon's Nutrition Basics: Foods That Heal
  • MoonDragon's Nutrition Basics: The Micronutrients: Vitamins & Minerals
  • MoonDragon's Nutrition Basics: Avoid Overcooking Your Foods
  • MoonDragon's Nutrition Basics: Phytochemicals
  • MoonDragon's Nutrition Basics: Increase Your Consumption of Raw Produce
  • MoonDragon's Nutrition Basics: Limit Your Use of Salt
  • MoonDragon's Nutrition Basics: Use Proper Cooking Utensils
  • MoonDragon's Nutrition Basics: Choosing The Best Water & Types of Water


  • MoonDragon's Nutrition Information Index
  • MoonDragon's Nutritional Therapy Index
  • MoonDragon's Nutritional Analysis Index
  • MoonDragon's Nutritional Diet Index
  • MoonDragon's Nutritional Recipe Index
  • MoonDragon's Nutrition Therapy: Preparing Produce for Juicing
  • MoonDragon's Nutrition Information: Food Additives Index
  • MoonDragon's Nutrition Information: Food Safety Links
  • MoonDragon's Aromatherapy Index
  • MoonDragon's Aromatherapy Articles
  • MoonDragon's Aromatherapy For Back Pain
  • MoonDragon's Aromatherapy For Labor & Birth
  • MoonDragon's Aromatherapy Blending Chart
  • MoonDragon's Aromatherapy Essential Oil Details
  • MoonDragon's Aromatherapy Links
  • MoonDragon's Aromatherapy For Miscarriage
  • MoonDragon's Aromatherapy For Post Partum
  • MoonDragon's Aromatherapy For Childbearing
  • MoonDragon's Aromatherapy For Problems in Pregnancy & Birthing
  • MoonDragon's Aromatherapy Chart of Essential Oils #1
  • MoonDragon's Aromatherapy Chart of Essential Oils #2
  • MoonDragon's Aromatherapy Tips
  • MoonDragon's Aromatherapy Uses
  • MoonDragon's Alternative Health Index
  • MoonDragon's Alternative Health Information Overview
  • MoonDragon's Alternative Health Therapy Index
  • MoonDragon's Alternative Health: Touch & Movement Therapies Index
  • MoonDragon's Alternative Health Therapy: Touch & Movement: Aromatherapy
  • MoonDragon's Alternative Therapy: Touch & Movement - Massage Therapy
  • MoonDragon's Alternative Health: Therapeutic Massage
  • MoonDragon's Holistic Health Links Page 1
  • MoonDragon's Holistic Health Links Page 2
  • MoonDragon's Health & Wellness: Nutrition Basics Index
  • MoonDragon's Health & Wellness: Therapy Index
  • MoonDragon's Health & Wellness: Massage Therapy
  • MoonDragon's Health & Wellness: Hydrotherapy
  • MoonDragon's Health & Wellness: Pain Control Therapy
  • MoonDragon's Health & Wellness: Relaxation Therapy
  • MoonDragon's Health & Wellness: Steam Inhalation Therapy
  • MoonDragon's Health & Wellness: Therapy - Herbal Oils Index

  • For a full list of available products from Mountain Rose Herbs, click on banner below:

    Starwest Botanicals

    HerbsPro Supplement Store


    Up to 70% Off Bath & Beauty - evitamins


 Herbs, Foods, Supplements, Bath & Body

    Chinese Herbs Direct

    Ayurvedic Herbs Direct

    Pet Herbs Direct

    Wild Divine - Stress relief training software and meditation.

    Aleva Health - Hosiery, Orthopedics, Wound Care, Support, Diabetic Socks

    ShareASale Merchant-Affiliate Program


    A website map to help you find what you are looking for on's Website. Available pages have been listed under appropriate directory headings.