Clinical Analysis of Atypical Kawasaki Disease : Comparison of Kawasaki Disease Between Typical and Atypical Types |
Eun Ju Jeong1, Jae Hong Park2, Hee Ju Park2 |
1Department of Pediatrics, Kwang Hye General Hospital, Pusan, Korea 2Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea |
비정형 가와사끼병의 임상적 고찰 : 정형 가와사끼병과의 비교 |
정은주1, 박재홍2, 박희주2 |
1광혜병원 소아과 2부산대학교 의과대학 소아과학교실 |
Correspondence:
Hee Ju Park, Email: phj@hyowon.pusan.ac.kr |
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Abstract |
Purpose : Kawasaki disease(KD) is known as one of the most important causes of acquired heart
disease in children. But the incidence of acquired heart disease can be reduced by early diagnosis
and treatment with large amounts of intravenous γ-globulin(IVGG). For early diagnosis and treatment
of atypical KD, we analyzed and compared the clinical features, laboratory findings and coronary
lesions in patients with typical or atypical KD.
Methods : A retrospective chart review was conducted in all children with Kawasaki disease who
were admitted to the Department of Pediatrics of Kwang-Hye Hospital between January 1998 and
December 1999. Except for 15 cases who were not followed, 62 cases were involved in this study.
We analyzed and compared the clinical features, laboratory findings and coronary lesions in patients
with 39 typical cases and 23 atypical cases of KD.
Results : The lowest incidence among clinical symptoms was cervical lymphadenopathy in both
groups. In atypical cases, cervical lymphadenopathy, polymorphous exanthema, and changes of peripheral
extremities were significantly lower than in typical cases. The duration of fever was similar
in both groups, the mean defeverescence time after administration of IVGG in atypical cases
was significantly shorter than typical cases(atypical, 2.6 days, typical cases, 1.8 days). The coronary
artery dilatation appeared in 4 cases(17.4%) of atypical and 17 cases(43.6%) of the typical
group. In most cases of both groups, left coronary artery dilatation was detected.
Conclusion : To decrease the incidence of serious coronary complications due to atypical KD,
careful evauation of clinical findings, early study of echocardiography and early infusion of large
doses of IVGG are needed. |
Key Words:
Kawasaki disease, Atypical, Echocardiography |
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