JAKARTA - The number of Kawasaki disease cases in children in Indonesia is estimated to reach thousands per year, with most of them undiagnosed. In many cases, Kawasaki is not recognized from the beginning because the symptoms are often mistaken for other diseases.
Kawasaki disease is an inflammation or inflammation that occurs in arteries or blood vessels that are often experienced by children under the age of five. Inflammation tends to appear in the coronary arteries that supply blood to the heart muscle. This is what can cause heart disease later.
Prof. Dr. D. Najib Advani, Sp.A, Subsp.Kardio (K), M.Med (Paed) believes that the number of cases of Kawasaki disease in children reaches thousands per year, but most of them have not been diagnosed.
It is not known for sure what causes Kawasaki, but this disease has symptoms similar to other diseases so it is often difficult to identify.
Many Cases are UnidentifiedKawasaki disease was first discovered in Japan by dr. Tomisaku Kawasaki in 1967. This disease is a systemic vasculitis syndrome whose cause is not known for certain and is most often found in children or infants.
Kawasaki disease is mostly found in the Asia Pacific region. The prevalence in the United States is 19 out of 100,000 children, while in Japan it is 175 out of 100,000 children. In Indonesia, dr. Najib started to socialize and handle it since 1999 and has handled more than 2,000 cases.
Until now, the incidence of Kawasaki disease is estimated to reach 5,000 new cases each year, but only about four percent or less than 200 cases can be diagnosed and documented.
Doctor Najib Advani said that many cases of Kawasaki were not recognized from the beginning because the symptoms were often mistaken for other diseases. This delay in diagnosis can increase the risk of serious complications in children with Kawasaki disease.
"If it is not treated, 15-20 percent of children will suffer from coronary arteries," said Dr. Najib in an online seminar entitled Kawasaki in Children held by the Indonesian Pediatric Association (IDAI).
Delay in diagnosis, Dr. Najib added, makes children in a condition where coronary artery stenosis has occurred which increases the risk of heart attacks and subsequent actions such as heart bypass surgery.
Najib added that Kawasaki disease most often attacks children under the age of five, especially one to two years of age, and more often occurs in boys than girls.
Beware of Early SymptomsThe cause of Kawasaki disease is still not known for certain and is still being further investigated. Dr. Najib said that Kawasaki disease in children is often not recognized from the beginning because the symptoms are similar to other infectious diseases.
In general, Kawasaki disease is characterized by high fever that lasts at least five days and does not improve with antibiotics. Several typical clinical signs can be seen from the eyes, mouth, skin, and lymph nodes.
"The main symptoms are persistent fever. Then red eyes without dirt (belek), red and cracked lips, the tongue looks like strawberries, rashes on the skin, and the palms and feet look red and swollen," said Najib.
Enlargement of the lymph nodes in the neck also often appears in patients, but these signs are not always present simultaneously so that the diagnosis can be missed at the initial examination.
"The symptoms can appear gradually, not always at once. Today you have a fever, tomorrow you have a rash, then red eyes. Therefore, it needs monitoring," added Dr. Najib.
In a number of cases of Kawasaki in children, many suspect it as measles, viral infection, to appendicitis due to abdominal pain and diarrhea.
In addition, Dr. Najib also highlighted another typical sign that is often missed, namely the BCG (Bacillus Calmette Guerin) vaccine injection mark on the arm that appears red and inflamed again during the acute phase of Kawasaki.
"The former BCG can turn red and be active again. That is an important clue that can be seen directly without complicated examinations," said Najib.
Kawasaki is often considered a rare disease. Although it is believed to improve on its own, treatment is still needed to prevent the occurrence of various other conditions and dangerous complications.
Doctor Najib, who is included in the IDAI Cardiology Coordination Working Unit, reminded that with early treatment, the risk of coronary artery abnormalities can be suppressed to around two to three percent. For this reason, he emphasized the importance of parental vigilance and health workers to early symptoms and rapid referral to pediatricians and pediatric cardiologists.
The English, Chinese, Japanese, Arabic, and French versions are automatically generated by the AI. So there may still be inaccuracies in translating, please always see Indonesian as our main language. (system supported by DigitalSiber.id)
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