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Thursday, May 29, 2008
Kawasaki Disease
Yesterday, I was able to handle a patient with a very rare illness called Kawasaki disease. It's an illness that involves the skin, mouth, and lymph nodes, and most often affects kids under age 5. My patient was a 2 years old girl. The cause for this kind of disease is still unknown, but if the symptoms are recognized early, kids with Kawasaki disease can fully recover within a few days. Untreated, it can lead to serious complications that can affect the heart.
Kawasaki disease is very rare here in the Philippines. It is most common among Japanese children. That's why it's called "Kawasaki". I interviewed my patient's mom. I asked her if there's any Japanese descent in their family. Unexpectedly, there is none.
There is no prevention for this disease. There are also no definite diagnostic test for early detection of this disease. Doctors usually just base their impression from it's signs and symptoms.
At the first phase of the disease, which can last for up to 2 weeks, usually involves a persistent high fever. The fever lasts for at least 5 days. When I assessed my patient, I found out lots of symptoms that really indicates that she's suffering from Kawasaki. There are severe redness in the eyes; red, dry, cracked lips; swollen tongue with a white coating and big red bumps; and sore, irritated throat. She also have swollen palms on her hands and soles of the feet with a purple-red color. That's why I have hard time inserting an IV canula to her vein for IV-IG infusion.
IV-IG infusion is the usual treatment for this disease. It's an intravenous doses of gamma globulin (purified antibodies), an ingredient of blood that helps the body fight infection. For my patient's case, I need to infuse 10 bottles of IV-IG. Each vial contains 50ml of IV-IG that I need to transfuse one by one using an infusion pump. One vial of IV-IG cost a shocking price of Php15,000. So, for a total of 10 vials, my patient bought it for a more shocking price of Php150,000. That's why I am very careful of handling each vials...making sure not to break them.
A high dose of aspirin may also be given for this kind of patient. It is taken to reduce the risk of complication--heart problems. If Kawasaki disease is treated within 10 days of the onset of symptoms, heart problems usually do not develop.
Cases that go untreated can lead to more serious complications, such as vasculitis, an inflammation of the blood vessels. This can be particularly dangerous because it can affect the coronary arteries, which supply blood to the heart. In addition to the coronary arteries, the heart muscle, lining, valves, and the outer membrane that surrounds the heart can become inflamed. Arrhythmias (changes in the normal pattern of the heartbeat) or abnormal functioning of some heart valves also can occur.
Kawasaki disease is very rare here in the Philippines. It is most common among Japanese children. That's why it's called "Kawasaki". I interviewed my patient's mom. I asked her if there's any Japanese descent in their family. Unexpectedly, there is none.
There is no prevention for this disease. There are also no definite diagnostic test for early detection of this disease. Doctors usually just base their impression from it's signs and symptoms.
At the first phase of the disease, which can last for up to 2 weeks, usually involves a persistent high fever. The fever lasts for at least 5 days. When I assessed my patient, I found out lots of symptoms that really indicates that she's suffering from Kawasaki. There are severe redness in the eyes; red, dry, cracked lips; swollen tongue with a white coating and big red bumps; and sore, irritated throat. She also have swollen palms on her hands and soles of the feet with a purple-red color. That's why I have hard time inserting an IV canula to her vein for IV-IG infusion.
IV-IG infusion is the usual treatment for this disease. It's an intravenous doses of gamma globulin (purified antibodies), an ingredient of blood that helps the body fight infection. For my patient's case, I need to infuse 10 bottles of IV-IG. Each vial contains 50ml of IV-IG that I need to transfuse one by one using an infusion pump. One vial of IV-IG cost a shocking price of Php15,000. So, for a total of 10 vials, my patient bought it for a more shocking price of Php150,000. That's why I am very careful of handling each vials...making sure not to break them.
A high dose of aspirin may also be given for this kind of patient. It is taken to reduce the risk of complication--heart problems. If Kawasaki disease is treated within 10 days of the onset of symptoms, heart problems usually do not develop.
Cases that go untreated can lead to more serious complications, such as vasculitis, an inflammation of the blood vessels. This can be particularly dangerous because it can affect the coronary arteries, which supply blood to the heart. In addition to the coronary arteries, the heart muscle, lining, valves, and the outer membrane that surrounds the heart can become inflamed. Arrhythmias (changes in the normal pattern of the heartbeat) or abnormal functioning of some heart valves also can occur.
21 Comments:
basta ang natatandaan ko sa kawasaki dse is that hindi sya nagrerespond sa paracetamol or ibuprofen during the onset of fever, ska parang yung arrythmias can either lead to mayocardial infarction sabi ng CI ko.
wow, galing ah, so you better be careful pala talaga sa mga vials, ang mamahal! Good luck :D
kawawa naman.. bakit kaya mga bata pa ang tinatamaan?
ang mahal pala non.. magiging isa rin kaya ako sa mga katulad mo na ganon ang gagawin in the future? (rare disease + expensive vial thingy)...o.o
WOW! may ganon palang disease...did i say WOW? ay mali pala.. ahehhe
@ daniel,
sa patient ko kasi, nawawala yung fever nya pag nagbigay ng paracetamol. kaya lang, talagang round the clock. yung fever lang ang na-ti-treat ng paracetamol..but not the disease.
yup, pede nga magka-myocardial infarction. Galing!
(pede ka na sumabay sa magtetake ng board exam ngayon june.hehe.)
@ kate,
nakaka-awa talaga sya...at lalo na yung bulsa ng family nila. tsk tsk..naalala ko yung kay ariane.:( half a million.:O
ma-experience mo rin 'to pag RN ka na.
@ tanom,
Wow!:O talagang wow sa presyo ng gamot!
kaya...mag-nursing ka na. haha!
ei. first time here.
sad to know that a young girl is suffering from a rare dse pro adik siya sa gamot ha. buti her family is compliant with the medications, impt pa naman un.
:)thanks sa pagdaan sa 'kin.
My son had KD when he was 4 years old but he was not administered with IVIG. Pang 11th day na kasi ng fever. He was just given aspirin for two weeks. We had to let him undergo 2d echo tests twice a year until his arteries were cleared. Nag balloon slightly daw kasi because of KD. He's now 9 years old and doing well. But then, everytime he has fever, I tend to suspect it's KD again because he was never treated with IVIG.
KD being rare in the Philippines is not that true. When my son had Kawasaki in 2004, I already met with other KD parents residing in Manila. In fact, when my son was hospitalized, 3 cases of KD ang kasabay niyang na-confine sa hospital. All of the Pinoy KD kids we were able to meet do not come from Japanese lineages. What was common among us was that we had carpets in the house and that our kids had their scheduled immunization before they got hit with KD.
Kawasaki is not rare here in the Philippines. If memory serves me right, my doctor said it affects 1 for every 1000 kids. My doctor has seen patients with Kawasaki here in the Philippines as far back as 20+ years ago. It's also not called Kawasaki because it's common among Japanese kids - it's called Kawasaki because that's the name of the doctor who discovered the disease.
Hey where can you get the IVIG ? I saw a tweet who needs help with this..please reply asap thanks
hi. my daughter had KD more than 3 years ago and now my youngest son - 7 months old have KD also. IVIG cost 12,000 per vial now. they say its cheaper if we buy it outside the hospital (you can get it at zuellig pharma) will be only 8,000 +..
if anyone needs more info you can email me at cecil_deguzman@yahoo.com
May kilala ba kayong doctor na expert sa KD? gusto ko ipa check up 6 month old son ko
hi my niece has just been diagnosed with KD. She is four years old and will be 5 in May, she weighs 18kilos. The doctor says she needs about 15 vials of IVIG at 8k+/vial. Has anyone's child of the same age needed this much? Just wanted to know.
many thanks on all your inputs here.. i will be visiting this thread regularly as i am still in search of some financial assistance i heard is being offered by some pediatricians with noble heart. our caretaker's son was diagnosed with this disease and we were hopeless upon hearing of the cost.
Hi. My daughter was diagnosed with atypical kawasaki disease on the day of her 1st birthday. she had fever for a total of four days, had conjunctivitis (redness of the white part of the eyes,), and her blood tests showed high levels (way way above the normal ranges)of ESR and CR-P, both of which, though not indicative of KD, are indicative of inflammations, she had skin peeling around her fingernails and toenails, and red lips. She had a 2D echo done and the results showed small pericardial effusion (water in her heart) and trivial tricuspid regurgitation (some of the blood sort of backflows, instead of flowing through one direction only). Her pediatrician DID NOT recommend IV+IG and aspirin, because both are highly invasive and aspirin is linked to Reye's Syndrome. Instead, our daughter was treated with natural supplements, one for the heart, one for the arteries and another to boost immunity. Her repeat 2D echo after two weeks from the onset of fever showed absolutely normal results, the pericardial effusion resolved, and the doppler study didn't show the regurgitation anymore. those few weeks were the most trying weeks in our family's life, but thankfully, everything is okay now. If anyone needs information on my daughter's pediatrician, please feel free to message me at agnes_mm@yahoo.com. Hope this helps. :)
Hi my son also had kawasaki desease 6 months old pa lang siya 10 days syang nilalagnat suka tae last friday.Lahat ng laboratory nilagay sa kanya negative sa cbc,urine saka sa dumi ok naman para makasiguro nag 2d echo sya then lumabas sa result kawasaki desease nagulat kaming mag asawa halos mapaiyak ang mrs ko.sabi ng doctor need ng IVIG para magamot ung sakit problem kasi namamaga ung ugat sa puso.so we need to produce money almost 8t per vial need nya ng 7 so 56k lahat then take pa sya ng 3 tablet aspirin pa.Pagkatapos malagay ung gamot sabi ng doctor pag di sya nilagnat within 24 hours ok na ung baby namin pero kung hindi another IVIG uli halos mapaiyak na naman kami so ginawa naming mag asawa PRAY NA LANG KAMI SA GOD THEN HE HELP US after 24 hrs balik na sya sa normal then ung aspirin he take half tablet na lang so GLORY TO GOD ALMIGHTY.kaya sa mga nakakabasa nito hope na makatulong sa inyo ito
please give me hospitals who has specialization in treating kawasaki disease...
can give me a call at 09094513263...
my niece suffers kawasaki disease...
Ung pinsan ko last week lang nadiagnose n may KD.. ang pinaka masakit sa lahat 8 days ng nsa National Children hospital ung pinsan ko pero d p din sya nabibigyan ng proper vaccine. Ang mga magulang ng pinsan ko ay d ganun kayaman.. nakakasurvive sila sa pangaraw araw at sapat lang ang income monthly. Di naman alam kung bakit siya nagkasakit. Ngayon ginagawa na namen ang lahat para mameet ang 60k amount n kailangan ng hospital para sa vaccine.. ayaw ksi nila tanggapin ung 20k n binibigay ng tito ko dapat daw 60k cash.. dahil ung gamot oorderin pa sa japan.. nagtanong kame sa mercury 11k isang vial... In god's will.. sana may makatulong sa pinsan ko. 2 years old pa lang siya.. Katulad ng mga storya nyo. Im hoping we will have the same happy ending story.. Hope everything will get better soon.
My daughter 3years old now my typical KD need to 2d echo this thursday to know the vial per grams n inject s kanya 13.4klg lng sya payat.. Anu kaya ang cost nun kindly help us san mkkkuha ng sponsor asap wla kmi pera at work.. Housewife ako at mekanico lng asawa ko need your help san kya ko pwde pumunta to rush the ivig tretment
My daughter 3years old now my typical KD need to 2d echo this thursday to know the vial per grams n inject s kanya 13.4klg lng sya payat.. Anu kaya ang cost nun kindly help us san mkkkuha ng sponsor asap wla kmi pera at work.. Housewife ako at mekanico lng asawa ko need your help san kya ko pwde pumunta to rush the ivig tretment
My daughter suffered KD and is now 1 week post IVIG treament. I have extra vials of IV IG 5g/100ml. Anyone in need may email me at ivychloezoe@gmail.com or text me at 0916 6939390. 11/26/14
My grandson was diagnosed with KD last week and needed 8 vials of 2.5gm. I called the no. 0917-8215267 and they have different brands of IVIG so you will have an option to choose depending on your doctor's preference or financial capability. They gave us a 5% discount for 8 vials.
My grandson was diagnosed with KD last week and needed 8 vials of 2.5gm. I called the no. 0917-8215267 and they have different brands of IVIG so you will have an option to choose depending on your doctor's preference or financial capability. They gave us a 5% discount for 8 vials. 9/28/17
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