Clinical Features of Atypical Kawasaki Disease |
Mi Young Heo, Su Jung Choi, Hae Soon Kim, Sejung Sohn |
Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea |
비정형 가와사키병의 임상 양상 |
허미영, 최수정, 김혜순, 손세정 |
이화여자대학교 의과대학 소아과학교실 |
Correspondence:
Sejung Sohn, Email: sohn@ewha.ac.kr |
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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 ≥5 days+major criterion+≥2 minor criteria, or fever of ≥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. |
Key Words:
Atypical Kawasaki disease |
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