"The majority of our society is not yet know about Kawasaki Disease (KD).
But, we have to mewaspadainya, because when the late managed can be fatal.
Kawasaki disease also known as mucocutaneous lymphnode syndrome is a disease
that usually strikes children and toddlers most often at the age of one to two
years. The disease is similar at first glance, drug allergy diseases, measles
virus infection, or even disease parotitis. Because it's a disease that was
discovered by the physician Tomisaku Kawasaki in Japan in 1967 is often wrong
diagnosis. "
Kawasaki disease has three phases, including:
The first phase is a phase of acute. In the acute phase, sufferers have
signs such as fever are sudden high and can reach 40 ° C for 5 days or more,
eyes are red but no poop, the palms of the hands and feet are red, and there
are red spots on the whole body. Lip, oral cavity, tongue, and people with any
red or often called Strawberry tongue. In addition people with experience
swelling of lymph nodes on one side of the neck, so it is often considered a
disease of parotitis (parotitis).
The second phase is the phase of the sub acute. This phase, which began on
the day of eleventh day of twenty-five until. In this phase, the fever had
already begun to decline and the red spots are reduced. Usually arise
Exfoliating skin fingers and toes. In this phase, sufferers experience a
complication to the heart of KD in coronary artery disease.
The third phase is the phase of healing. This phase occurs after
twenty-five days. On phase in horizontal bands arise on toenails and hands of
sufferers called Beau's line.
Dr. Najib Advani SpA (K), MMed. (Paed), consultant Pediatric Heart Disease
Kawasaki says many steeped in Indonesia this disease has already started is
known since the 1980s. most cases are diagnosed late KD. Whereas the number of
cases in Indonesia is estimated to be 5000 KD new cases per year. According to
Najib, the man who had been born into a greeting HAVANA since 1996, often
patients come too late, in the sense that they've been in the acute phase of
the sub where the heart abnormalities has already happened. Patients
experienced complications in coronary artery disease in the form of an aneurysm
or dilation (at 20-40 per cent of sufferers don't spontaneously heal) with
subsequent refinements occurred as a result of coronary artery disease that can
lead to fatal myocardial infarction.
"The barriers are not many doctors in the Indonesia who understand
this disease. Sometimes parents Kawasaki Disease sufferers who are actively
looking for information about this disease. The doctor said this pain and sick
of it. But parents who got information from internet asking if her son suffered
from Kawasaki Disease ", says Najib is a distinguished alumnus of the
University of Indonesia's Faculty of medicine.
Heart Complications
Dr. Najib Advani, head of the Coordination work of the heart child on
Indonesia's Bond Pediatrician says, the most worrying thing of Kawasaki Disease
is diagnosed when patients being late. Potentially having a heart attack
patient coronary removals.He explains this condition were derived from
disturbances in coronary blood vessels. State widens blood vessels, weakened,
prominent, or aneurysm. Coronary vessel constriction occurs next so that blood
flow to the heart muscle will be clogged. As a result the heart muscle is less
blood circulation or blood so don't get heart muscle death occurred with the
manifestation of a heart attack.
Other changes experienced by sufferers of inflammation (inflammation) of
the heart muscle (miokarditis) and the liquid in the bag that surrounds the
heart (perikarditis). Abnormal heart rhythm (arrhythmia) and inflammation of
the heart katuKDatup (valvulitis) can also occur. This can lead to sudden death
a few years later. When sufferers can be handled or declared to be healed by
doctors, in clinical coronary heart disease can appear later in adulthood.
The cost of expensive
According to Dr. Najib Advani due to unknown cause to KD this time haven't
been able to performed precautionary measures. Fortunately there are already
remedies to cure KD origin just isn't late. He explained that diagnosis and
treatment of Kawasaki Disease sufferers should get custody of the children's
cardiologists. Patients must be treated in inpatient hospitals and got
thoroughly monitoring.
"Examination of the heart becomes very important. Including ECG and
ekokardiografi (heart ULTRASOUND). Sometimes ultrafast CT scan, MRA (Magnetic
Resonance Angiography) and cardiac catheterization is required in that case.
Laboratory examination for the disease is no typical. Usually the number of
white blood cells, blood creep rate, and C Reactive Protein (CRP) increased in
acute phase, "said doctor Najib Advani.
Drug prices are expensive, he said, become obstacles in the process of
healing the patient. Kawasaki Disease patients should consume imunoglobulin
need drug two grams per one kilogram of body weight. The price of one gram of
IDR revolve around 1.2 million.
"If the sufferer has a weight of 15 Kg for example, means he needs 30
grams of imunoglobulin or costing about 36 million. In addition, patients are
also given imunoglobulin salicylic acid to prevent damage to the heart and the
coronary vessel blockage, "said cardiologist doctors this kid. He
explained, if it does not happen on the healing process, complication of
patients can be discharged in a few days. In the case of a late and coronary
vessel damage already happened, sufferers need a longer hospitalization and
intensive treatment in order to get prevent damage heart more.
Then when the drugs didn't work, sometimes required coronary bypass surgery
(bypass coronar), or even, although very rarely, a heart transplant. Death can
occur in one to five percent of sufferers are generally handled, and culminated
in the late going on 15-45 days after the initial onset of fever. If there is a
fever toddlers up to five days, his eyes and his lips are red, the possibility
of having Kawasaki Disease. If so then parents need to think about the
possibility of bringing his son to the KD and cardiologists children in several
major hospitals which have the facilities fully equipped like pemeriksan heart
in PJT, RSCM
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