Kawasaki Disease: What You Need To Know

Kawasaki Disease: No Link to Travolta Death
Childhood Kawasaki Disease Unlikely Cause of Seizures in Travolta's Teenage Son Jett Travolta
By Daniel J. DeNoon
Reviewed by Louise Chang, MD

Jan. 5, 2009 -- Jett Travolta's childhood brush with Kawasaki disease is highly unlikely to have caused the seizures that may have led to his death, a Kawasaki expert tells WebMD.

Jett Travolta, the 16-year-old son of actors John Travolta and Kelly Preston, died on Jan. 2. The teen, known to have suffered frequent seizures, struck his head against the bathtub in the hotel where his family was staying, according to media reports.

Kawasaki disease is a mysterious and frightening illness. Might Kawasaki disease have caused Jett Travolta's seizures?

WebMD asked Kawasaki disease expert Nathan Litman, MD, chief of infectious disease and director of pediatrics at New York's Montefiore Medical Center.

"I am unaware of any association of Kawasaki disease with seizures," Litman tells WebMD.

Kawasaki disease can leave a person with an abnormally narrow coronary artery, and this can lead to a future heart attack. Early reports suggest Jett Travolta did not suffer a heart attack; an autopsy is under way.
Kawasaki Disease: Mysterious Ailment on the Rise

Nobody knows what causes Kawasaki disease, but it can be deadly. It's not common in the U.S., although incidence is increasing in Japan.

First described in Japanese medical literature by pediatrician Tomisaku Kawasaki, MD, the disease is a disease of childhood. Litman says 80% of cases occur in children under 5. Cases are very rare in anyone over the age of 10.

John Travolta has said in interviews that his son had Kawasaki disease when he was about 2 years old. In an interview with CNN's Larry King in 2001, Travolta expressed the opinion that the illness was brought on by Jett's overexposure to cleaning products, particularly carpet cleaner.

Science has yet to discover the cause, although most researchers think it's an infectious agent, probably a virus.

That would account for why it strikes early in life, why most cases occur in the winter, and why there are Kawasaki outbreaks. But an infectious agent would likely spread in families, and Litman says it's rare to see more than one child in a family come down with Kawasaki disease.

The classic symptom of Kawasaki disease -- technically known as mucocutaneous lymph node syndrome -- is a high fever lasting for five days or longer. Other symptoms include:

* Pinkeye (conjunctivitis) in both eyes, but without purulent discharge.
* Redness of the lips, tongue, and lining of the mouth. Lips are often cracked or bleeding.
* A swollen cervical lymph node larger than 1.5 millimeters in diameter.
* A red rash on the body, which may be flat or bumpy and which may have different patterns.
* Changes in the extremities: swollen hands and feet with redness of the palms and soles. In the second week of illness, there may be peeling of the skin starting around the fingernails and extending to the arms.

Kawasaki disease is diagnosed when a child has five days of high fever and any four of the five symptoms listed above.

There may be other troublesome features, Litman says: swelling of the gallbladder, diarrhea, and painful swelling of the joints. But the scariest thing about Kawasaki disease is its possible effects on the heart.
Kawasaki Disease and Heart Trouble

"The most troublesome feature of Kawasaki disease is involvement of the heart," Litman says. "What worries everyone is that in the convalescent phase, about 10 days into the illness, there may be inflammation of the coronary arteries, which can result in aneurysm formation. This can cause turbulence throughout the artery and cause [narrowing] of the artery, which could cause a heart attack."

If not treated, one in five children with Kawasaki disease would get coronary aneurysms. Fortunately, treatment cuts this risk to about one in 20.

Treatment involves a high dose of immune globulin and a high-dose aspirin until the fever goes down. Once the fever goes away, the child's aspirin dose is reduced and doctors perform an echocardiogram to check for heart abnormalities.

"This generally results in a return to a happy state," Litman says. "In kids who do develop aneurysms, some may resolve, but this may still be a forerunner of adult-type coronary artery disease. They may be left with residual stenosis [narrowing of a heart artery] that can cause a future heart attack."

So if Kawasaki disease didn't cause Jett Travolta's seizures, what did? Seizures are the result of an electrical storm in a part of the brain. Some people simply develop frequent seizures for no apparent reason. Sometimes the cause is a trauma, infection, or tumor.

Media reports have suggested that Jett Travolta may have suffered from autism. The Church of Scientology, of which his parents are members, does not believe that autism is a valid diagnosis, and the Travolta family has rejected the idea that Jett had autism.

However, among children diagnosed with autism, there is a high prevalence of seizure disorder.

SOURCES:

Nathan Litman, MD, chief of infectious disease and director of pediatrics, Montefiore Medical Center, New York.

WebMD Medical Reference from Healthwise: "Kawasaki Disease Overview."

Levisohn, P.M. Epilepsia, 2007; vol 48: pp 33-55.

Associated Press.

CNN.com

TMZ.com