Cerebrospinal fluid profile in patients with acute Kawasaki disease

BACKGROUND.Kawasaki disease (KD) is an acute vasculitis of infancy and early childhood for which there is currently no diagnostic test. The clinical presentation of KD may initially resemble other infectious diseases, including bacterial or viral meningitis. For this reason lumbar puncture (LP) is s...

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Bibliographic Details
Published in:	The Pediatric infectious disease journal Vol. 17; no. 6; pp. 478 - 481
Main Authors:	DENGLER, LAURA D, CAPPARELLI, EDMUND V, BASTIAN, JOHN F, BRADLEY, DAVID J, GLODE, MARY P, SANTA, SANDRA, NEWBURGER, JANE W, BAKER, ANNETTE L, MATSUBARA, TOMOYO, BURNS, JANE C
Format:	Journal Article
Language:	English
Published:	Baltimore, MD Williams & Wilkins 01-06-1998 Philadelphia, PA Lippincott Hagerstown, MD
Subjects:	Acute Disease Biological and medical sciences Child Child, Preschool Female Humans Infant Male Medical sciences Mucocutaneous Lymph Node Syndrome - cerebrospinal fluid Mucocutaneous Lymph Node Syndrome - diagnosis Mucocutaneous Lymph Node Syndrome - drug therapy Retrospective Studies Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Human Kawasaki syndrome Immunopathology Biochemical analysis Acute Cardiovascular disease Autoimmune disease Exploration Cerebrospinal fluid Vascular disease Vasculitis Systemic disease Child
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Summary:	BACKGROUND.Kawasaki disease (KD) is an acute vasculitis of infancy and early childhood for which there is currently no diagnostic test. The clinical presentation of KD may initially resemble other infectious diseases, including bacterial or viral meningitis. For this reason lumbar puncture (LP) is sometimes performed during the evaluation of these patients. To understand the range of cerebrospinal fluid (CSF) changes that may be associated with acute KD, a retrospective review of unselected KD patients from three pediatric centers was performed. METHODS.Retrospective chart review was performed on KD patients evaluated during the first 10 days of illness who had an LP performed before the administration of intravenous gamma-globulin. RESULTS.During the 6.5-year study period, 46 KD patients underwent LP as part of their clinical evaluation. Of these patients 18 (39.1%) had CSF pleocytosis, 1 (2.2%) had a CSF glucose <45 mg/dl and 8 (17.4%) had an elevated CSF protein. Of the patients with CSF pleocytosis, the median white blood cell count was 22.5 cells (range, 7 to 320 cells), with a median of 6.0% neutrophils (range, 0 to 79%) and 91.5% mononuclear cells (range, 11 to 100%). CONCLUSIONS.In the present series approximately one-third of KD patients who underwent an LP had CSF pleocytosis with a mononuclear cell predominance. No patient had significant hypoglycorrhachia, and elevation of the CSF protein was uncommon. CSF abnormalities were similar between US and Japanese KD patients. The basis for the CSF pleocytosis in acute KD patients remains unknown.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0891-3668 1532-0987
DOI:	10.1097/00006454-199806000-00008