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Treatment

Find out more about how Kawasaki Disease is first treated, and the future treatments you might receive if you have lasting heart damage

How is Kawasaki Disease treated?

There’s two parts to this one!

The first bit is about when children first get Kawasaki Disease:

Children are treated in hospital by specialist doctors. The treatment given is called “intravenous immunoglobulin”. That’s a bit of a mouthful – we’ll call it IVIG instead! It’s a very precious treatment made from blood donations. It’s an amazing treatment which quickly stops the inflammation happening in a child’s body when they get Kawasaki Disease. The other medicine given at the same time as IVIG is aspirin. Unlike IVIG, you’ve probably heard of aspirin! It has the same sort of effect as IVIG, helping to reduce the inflammation. Sometimes children are also given corticosteroids (steroids). You’ll probably guess – and you’d be right – these also work to reduce inflammation.  All these treatments “switch off” the high temperature and inflammation (which is the thing causing all the other symptoms like red eyes and a rash) and also help to cut down the chance of heart damage.  Sometimes other drugs are used as well, but – yes – you guessed it, these also work to stop inflammation!

There’s more information on IVIG and aspirin if you scroll down the page. You can also find out some more information here on our question and answers page.

Getting Kawasaki Disease known

Today doctors understand that early treatment is key to reduce the risk of heart damage in children with Kawasaki Disease. It might have been 10 or 15 years since you first had Kawasaki Disease. Back then, Kawasaki Disease was both less well known and not as well understood. Double whammy! Today we know Kawasaki Disease needs urgent treatment for the best chances of a good recovery. So our charity, Societi Foundation – the U.K. Foundation for Kawasaki Disease works to raise awareness so that children can get the rapid treatment they need.

OK – so that’s the initial treatment. What else?

Well, if Kawasaki Disease caused heart damage, children, young people and adults affected go on to need lifelong medication. The exact treatment needed depends on just how, and how much their heart was damaged.

Treatments include medicines called anticoagulants which make blood clots less likely and so help reduce the risk of what doctors call “cardiac events” – possible future heart problems. So treatments, and the individual care you have from your doctor, are designed to reduce this risk and keep you well. It’s this risk of serious illness in later life, for some people who have severe heart damage, which makes Kawasaki Disease so serious.

Intravenous Immunoglobulin (IVIG)

We mentioned this above – and IVIG is a really key treatment in Kawasaki Disease when children are first ill with it. Early treatment as soon as a Kawasaki Disease diagnosis is confirmed is so (so!) important – because research shows that early treatment significantly reduces the chance of damage to a child’s heart.

You might have been treated with IVIG when you were first ill with Kawasaki Disease as a child.

IVIG is a blood product made from donated blood. It’s a concentrated source of antibodies – the things in your blood which help to fight infection and calm inflammation or swelling. It’s amazing – a bit of a super-treatment, because it can help children begin their recovery from Kawasaki Disease very quickly after treatment starts, though it’s not completely magic unfortunately. We know from research that it doesn’t prevent aneurysms (widenings in the blood vessels in the heart) occurring altogether. BUT – it does help minimise the amount of possible damage in most children. It works by reducing the high temperature and to quickly ‘damp down’ inflammation that Kawasaki Disease causes throughout the body.

Immunoglobulin is a blood product which might sound scary! But don’t worry – when it is being made, it is carefully checked to make sure it is as safe as possible. The volume of immunoglobulin needed for a treatment in a child with Kawasaki Disease is quite large – so the treatment runs as an infusion (through a drip, in hospital) usually over 12 hours.

Sometimes children can react to treatment with immunoglobulin. They might get chills, start sweating, be pale or have redness and blotching of the skin. A child’s blood pressure may be raised whilst they are on the drip. But these things stop when the treatment stops – and because children are in hospital when they have IVIG, they are really closely monitored by specialist doctors.

After treatment with IVIG, doctors advise that children should avoid having any live vaccinations, just for six months. This is only because the antibodies the IVIG contains may mean that vaccines would not be effective.

Aspirin

There’s two parts to this one too!

Aspirin when you’re first ill with Kawasaki Disease

You will probably have been treated with aspirin (usually dissolved in water, taken by mouth) in high doses when the diagnosis is first made. The dose of aspirin is much more than you would normally give someone for a fever. The amount of aspirin given will be calculated based on your weight, (so many milligrams of aspirin per kg of weight). The aspirin treatment is used to reduce the fever, calm inflammation and alleviate soreness in the body. When your fever fully settles, usually at about 10 days into the illness, the aspirin will be decreased to a lower dose. This lower dose is given to prevent the blood from clotting inside any blood vessel or in aneurysms that might form.  Aspirin medication will need to continue until at least 6 weeks from the start of the illness – when an echocardiogram (ultrasound scan of the heart) will be performed to check for any damage to the heart.

Aspirin as a long term treatment

In children who develop coronary artery abnormalities, low dose aspirin may be continued indefinitely or long term. However, this dose is very small and is safe to take. You can find out more about low dose aspirin on the NHS website here.

Another long term medicine often used is Clopidigrel. This is like aspirin in the effect it has – it is an antiplatelet medicine which means it helps to ensure your blood is less likely to clot. Clopidogrel is another antiplatelet medicine which is sometimes used with aspirin or instead of it, as an alternative for young people who have had Kawasaki Disease and have an increased risk of a blood clot.

 

The video below is of Dr Owen Miller –  a top Kawasaki Disease expert and Consultant paediatric cardiologist. Owen gives his thoughts on taking aspirin long term.

 

 

Anticoagulants

Anticoagulants are specialist medicines used to reduce the likelihood of blood clots forming. If you’re taking – or have just been prescribed anticoagulation medicines (called anticoagulants), it is because you have a coronary artery aneurysm, or widening in the blood vessels in your heart, which might be a space in which blood flow can slow. When blood flow slows, it likes to clot. In fact, it is designed to do this. There are pretty cool substances in everyone’s blood which mean if you cut yourself, a clot forms. That means you don’t carry on bleeding and the cut can heal under the clot (or scab). Clever eh? When a clot happens in your bloodstream or in a blood vessel though – this isn’t so clever! In fact it can be pretty serious and the clot can form a blockage, which might lead to you being seriously unwell and needing urgent hospital care.

The chance of getting blood clots inside your body can be reduced a lot by taking anticoagulants. These medicines are sometimes described as ‘blood thinners’ – which we think is a bit weird! Because anticoagulants are medicines that prevent blood from clotting as quickly or as effectively as normal, but your blood isn’t actually made any thinner – it just does not clot so easily!

You can find out more information about some of these medicines from the NHS website. For the two most common anticoagulants used in Kawasaki Disease – here are the links – warfarin and heparin.