Clinical manifestations of Kawasaki disease: what are the significant parameters?

The initial differential diagnosis of Kawasaki disease (KD) from other acute febrile illnesses infants and children is particularly difficult in patients who exhibit incomplete criteria. The objective of this study was to determine the differences in the clinical and laboratory findings between KD p...

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Bibliographic Details
Published in:	Asian Pacific journal of allergy and immunology Vol. 27; no. 2-3; p. 131
Main Authors:	Chaiyarak, Kanoknaphat, Durongpisitkul, Kritvikrom, Atta, Thitiya, Soongswang, Jarupim, Laohaprasitiporn, Duangmanee, Nana, Apichart
Format:	Journal Article
Language:	English
Published:	Thailand 01-06-2009
Subjects:	Blood Sedimentation Body Weight Child Child, Preschool Coronary Aneurysm - complications Coronary Aneurysm - diagnosis Coronary Aneurysm - pathology Coronary Aneurysm - physiopathology Diagnosis, Differential Echocardiography Female Fever Humans Infant Infection - complications Infection - diagnosis Infection - pathology Infection - physiopathology Male Mucocutaneous Lymph Node Syndrome - complications Mucocutaneous Lymph Node Syndrome - diagnosis Mucocutaneous Lymph Node Syndrome - pathology Mucocutaneous Lymph Node Syndrome - physiopathology Platelet Count Predictive Value of Tests Retrospective Studies Sensitivity and Specificity
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Summary:	The initial differential diagnosis of Kawasaki disease (KD) from other acute febrile illnesses infants and children is particularly difficult in patients who exhibit incomplete criteria. The objective of this study was to determine the differences in the clinical and laboratory findings between KD patients and those who were initially sus- , pected of having KD but eventually had other diagnoses. One hundred and fourteen pediatric patients who were initially diagnosed with suspected KD were included. Eighteen cases were finally diagnosed with another disease. The only demographic data that were significantly different between the groups were body height and the duration of fever. The KD group exhibited more classical clinical criteria than those who were finally diagnosed with another disease. The erythrocyte sedimentation rate (ESR) and platelet count were significantly higher in the KD group than in the non-KD group. An ESR > or = 40 mm/hour had a diagnostic sensitivity of 90.5%, a specificity of 66.6%, a positive predictive value of 93.4%, and a negative predictive value of 57.1%. The incidence of coronary aneurysm in this study was 6.2%. There was no correlation between ESR and coronary aneurysm. We conclude that the clinical criteria are the basis for the diagnosis of Kawasaki disease but the ESR can be helpful in pediatric patients with acute febrile illness who do not exhibit all clinical criteria.
ISSN:	0125-877X