Spotlight on Asian American and Pacific Islander Month: Understanding Kawasaki Disease

Asian American and Pacific Islander (AAPI) Heritage Month celebrates the many contributions made by those of Asian and Pacific Islander descent in the U.S. Beginning in 1979, one week of early May was designated to Asian and Pacific Islander heritage. Since 1990, this celebration has been expanded to the full month of May.¹ This article discusses health issues and disparities specific to this population.

Asian Americans and Pacific Islanders may encounter additional barriers to American healthcare in comparison with Caucasians including lower rates of insurance coverage and language barriers. In addition, the use of complementary and alternative medicine may reduce the use of the American healthcare system or be used due to other barriers.2 Similar to all Americans, some leading causes of death in Asian American and Pacific Islanders include certain cancers, heart disease, stroke, and diabetes.3 These diseases can be present in any population. However, a rare disease called Kawasaki disease is prevalent in the Asian and Pacific Islander population.⁴

Kawasaki disease causes more than 5,000 hospitalizations each year.
Kawasaki disease, also known as Kawasaki syndrome, is named after the Japanese physician – Tomisaku Kawasaki – who first described the disease in 1967. Kawasaki disease causes inflammation in blood vessels and commonly affects coronary arteries. This may decrease blood supply and oxygen to the heart. Kawasaki disease also causes inflammation in other areas including lymph nodes, mouth, nose, throat, and eyes. Kawasaki disease affects those of Asian or Pacific Island descent and most commonly in children under 5 years of age. It is most common for the disease to occur in the winter and early spring in North America.⁴ In 2016, the Centers for Disease Control and Prevention reported 5,440 hospitalizations in the U.S. due to Kawasaki disease.⁵

Genetic or environmental factors may contribute to its cause.
The exact cause of Kawasaki disease is unknown. However, many scientists believe it may occur after an infection. There may be genetic or environmental factors. Children diagnosed with Kawasaki disease may present with a fever, rash, enlarged lymph nodes, red eyes, swollen or irritated tongue and lips, or swollen skin on the hands or feet.⁴ Without a specific test for Kawasaki disease, other conditions must be ruled out at the time of diagnosis.⁶

Kawasaki disease can lead to heart complications.
Due to the inflammation caused by Kawasaki disease, heart complications can occur. Up to 50% of patients will experience these complications. Weakened heart muscles, increased heart rate, heart valve abnormalities, bulging arteries, and decreased function in the heart’s lower chambers may lead to the heart not pumping blood efficiently. If severe, these changes may lead to life-threatening complications including heart failure and blood clot formation.⁷ 

Kawasaki diseases is treatable.
To reduce the possibility of long-term complications, it is important for treatment to be started as soon as possible after a Kawasaki disease diagnosis. Treatment includes intravenous immunoglobulin (IVIG) products and aspirin. IVIG helps to reduce inflammation in the heart and blood vessels. Aspirin helps to prevent blood clot formation and may be continued for at least 6 weeks. Kawasaki disease lasts about 12 days without treatment, but any complications can remain.⁶ 

Receiving IVIG and aspiring therapy improves symptoms quickly and reduces complications from about 20 percent to three to four percent when compared to aspirin alone. It is important to have a follow-up visit 6 to 8 weeks after diagnosis and again at 6 months. Although this appointment is important for everyone, it is especially important if heart problems did occur.^6,7

Pharmacists can help patients adhere to treatment.
Because the IVIG product is usually administered in a hospital setting, it may not be dispensed through a specialty pharmacy. However, pharmacists play an important role for these patients. Pharmacists can counsel the patients on IVIG use, the risks of using aspirin in young patients, specifically Reye’s syndrome (a rare but serious condition that causes swelling in the liver and brain), and explain the importance of the follow-up visits. This interaction may help patients adhere to treatment. Pharmacists are also in a position to minimize barriers in this population such as acquiring translation services.

Kawasaki disease is a rare and serious condition for those of Asian and Pacific Islander descent. Whether it is in medicine, science, engineering, or another area, each year there are thousands of accomplishments of the Asian American and Pacific Islander community that improves the lives of every American. AllianceRx Walgreens Pharmacy extends its thankfulness to this community and is happy to celebrate Asian American and Pacific Islander Heritage Month. 
    
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Sources:
¹ Asian American and Pacific Islander Heritage Month. History.com. Published April 5, 2022. https://www.history.com/topics/holidays/asian-american-pacific-islander-heritage-month. Accessed April 14, 2022.
² Lee S, Martinez G, Ma GX, et al. Barriers to health care access in 13 Asian American communities. Am J Health Behav. 2010;34(1):21-30. doi:10.5993/ajhb.34.1.3.
³ Profile: Native Hawaiians/Pacific Islanders. U.S. Department of Health and Human Services Office of Minority Health. Published October 12, 2021. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=65#:~:text=Some%20leading%20causes%20of%20death,HIV%2FAIDS%2C%20and%20tuberculosis. Accessed April 14, 2022.
⁴ Kawasaki Disease: Symptoms & Causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/symptoms-causes/syc-20354598. Accessed April 14, 2022.
⁵ Kawasaki Disease. Centers for Disease Control and Prevention. Published May 29, 2020. https://www.cdc.gov/kawasaki/about.html. Accessed April 14, 2022.
⁶ Kawasaki Disease: Diagnosis & Treatment. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/diagnosis-treatment/drc-20354603. Accessed April 14, 2022.
⁷ Kawasaki Disease. National Organization for Rare Disorders. Published 2009. https://rarediseases.org/rare-diseases/kawasaki-disease/. Accessed April 14, 2022.

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