Medications for Kawasaki Disease (Mucocutaneous Lymph Node Syndrome)
Kawasaki disease is a rare illness that mainly affects young children under the age of 5 years old, which causes swelling and inflammation within the walls of medium-sized arteries especially the heart arteries. Symptoms are long lasting fever, swollen glands in the neck, skin rashes, skin peeling, red eyes, and inflammation of the lips mouth and tongue. There is no specific test or definite symptom to diagnose Kawasaki disease, so instead Kawasaki disease is diagnosed by the child having a combination of the symptoms, and results from blood tests, ultrasound of the heart and by excluding other conditions that have similar symptoms.
Symptoms and Stages of Kawasaki disease
Kawasaki disease can last up to 6 to 9 weeks and symptoms change depending on which stage of the illness the child is in.
Early stage during the first week to 10 days:
fever over 102.2F (39C) which lasts at least 5 days but can last up to 25 days and is often unchanged with treatment with acetaminophen or ibuprofen
extreme irritability
swollen lips with vertical cracking and bleeding
inside the mouth is red and the tongue is swollen and red
red eyes without redness around the iris and without any discharge
rash on the trunk which may spread to arms, legs, face and around the nappy area
red and swollen hands and feet
swollen glands in the neck
inflammation of the heart muscle (myocarditis)
inflammation at the BCG vaccination site
Later stage from 2 weeks to 8 weeks:
fever, rash and swollen lymph nodes have resolved
irritability and red eyes persist
skin on fingers, toes and around the genital and anal area starts peeling off in thick layers
joint pain
thrombocytosis occurs, which is when there are too many platelets in the blood and this increases the chance of clots, stroke and heart attacks
aneurysms may develop at this stage and there is an increased risk of sudden death. An aneurysm is a weakening of an artery wall that creates a bulge of the artery, it may rupture or burst which can be fatal.
What is the cause of Kawasaki disease?
The cause of Kawasaki disease is currently unknown but is thought occur after an infection that triggers an autoimmune response. This means that the infection has activated the immune system but for some reason there is an abnormal immune response and it causes damage to parts of the body.
Who gets Kawasaki disease?
Some people are more likely to get Kawasaki disease
usually it affects children under 5 years old.
ratio of boys to girls is 1.5 : 1
Japanese and Korean people are thought to be more genetically susceptible to Kawasaki disease.
Complications of Kawasaki disease.
Cardiovascular:
heart disease acquired in childhood
coronary artery aneurysms
transient coronary artery dilation
myocardial infarct
rupture of a large coronary artery aneurysm
Other complications:
gastrointestinal complications
eye changes
neurological complications
death
Diagnosis
Diagnosis of Kawasaki disease is based on the child's symptoms and how they progress. Blood tests and heart ultrasounds are also done. As the symptoms can be similar to other conditions it is important to exclude any other conditions.
Treatment of Kawasaki Disease
It is important to start treatment for Kawasaki disease as soon as possible, and treatment often starts in hospital.
Aspirin is used to treat inflammation, decrease pain and reduce fever. Aspirin is not usually given to children so should only be given under the supervision of a doctor.
Gamma globulin is an immune protein that is give intravenously to reduce the future risk of coronary artery problems
Pediatric Multisystem Inflammatory Syndrome
Pediatric Multisystem Inflammatory Syndrome (PMIS) symptoms are systemic inflammation, persistent fever, conjunctivitis, fever, rash and diarrhea so these symptoms are similar to Kawasaki disease. PMIS has possible links to the COVID-19 outbreak of 2020. As the SARS-CoV-2 infection and the illness COVID-19 are recent developments, information on how PMIS relates to Kawasaki disease is currently unknown.
Drugs used to treat Kawasaki Disease
The medications listed below are related to or used in the treatment of this condition.
For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity
Activity is based on recent site visitor activity relative to other medications in the list.
Rx
Prescription only.
OTC
Over-the-counter.
Rx/OTC
Prescription or Over-the-counter.
Off-label
This medication may not be approved by the FDA for the treatment of this condition.
EUA
An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Expanded Access
Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.
Pregnancy Category
A
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N
FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
M
The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U
CSA Schedule is unknown.
N
Is not subject to the Controlled Substances Act.
1
Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2
Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3
Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4
Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5
Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X
Interacts with Alcohol.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
