Clinical Features of Atypical Kawasaki Disease.
- Author:
Mi Young HEO
1
;
Su Jung CHOI
;
Hae Soon KIM
;
Se Jung SOHN
Author Information
1. Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea. sohn@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Atypical Kawasaki disease
- MeSH:
Anemia;
Conjunctivitis;
Coronary Vessels;
Early Diagnosis;
Erythrocytes;
Exanthema;
Fever;
Hematocrit;
Humans;
Infant;
Mucocutaneous Lymph Node Syndrome*;
Retrospective Studies
- From:Journal of the Korean Pediatric Society
2002;45(3):376-382
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To identify clinical and laboratory features of atypical Kawasaki disease(KD), and to develop criteria for early diagnosis of atypical KD patients. METHODS: All patients with KD treated at our hospital from January 1998 to June 2000 were reviewed retrospectively. RESULTS: Among a total of 167 patients, 28(16.8%) were atypical KD of which seven(25%) were infants. Among the five cardinal symptoms, oral mucosal change(96.4%) occurred most frequently, followed by conjuntivitis(57.1%) and rash(46.4%). Most notable laboratory findings were anemia, and increased erythrocyte sedementation rate(ESR) or C-reactive protein(CRP). Coronary artery abnormalities developed in seven(25.8%) atypical KD patients, compared with 14.4% in typical KD patients. We considered oral mucosal change as major criterion, and conjunctivitis, rash, hematocrit <35% and ESR >30 mm/hr or CRP >3.1 mg/dL as minor criteria. Proposed modification in diagnostic criteria for atypical KD include fever of >or=5 days;major criterion+>or=2 minor criteria, or fever of >or=5 days+4 minor criteria. CONCLUSION: The modified diagnostic criteria has yielded a sensitivity 89.3%. Our diagnostic criteria may be used for early diagnosis of atypical KD.
