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Usefulness of echocardiographic findings in the early diagnosis of Kawasaki disease

Korean Journal of Pediatrics 2007;50(1):47-51.
Published online January 15, 2007.
Usefulness of echocardiographic findings in the early diagnosis of Kawasaki disease
Chang Hwan Choi, Sung Hwan Byun, Je Duk Jeon, Jong-Woon Choi
Department of Pediatrics, Bundang Jesaeng General Hospital, Seongnam, Korea
가와사끼병의 조기 진단에서 심장초음파검사의 유용성
최창환, 변성환, 전제덕, 최종운
분당제생병원 소아과
Correspondence: 
Jong-Woon Choi, Email: cjw@dmc.or.kr
Abstract
Purpose
: The early diagnosis of Kawasaki disease (KD) is difficult sometimes, especially in atypical or incomplete cases presenting 4 or less principal clinical features without coronary arterial lesions (coronary arterial ectasia or aneurysm). The authors investigated the incidence of echocardiographic abnormalities in patients with KD to discover whether abnormal echocardiographic findings might be helpful in the early diagnosis of KD.
Methods
: Echocardiography was done in the acute stage of 103 patients with KD (Kawasaki group) and 40 patients with other acute febrile illnesses (control group). Abnormal echocardiographic findings were classified into 4 categories and defined as follows; 1) significant pericardial effusion, 2) significant valvular dysfunctions, 3) left ventricular systolic dysfunction, 4) coronary arterial ectasia or aneurysm.
Results
: In the Kawasaki group, significant pericardial effusion was present in 24 patients (23.3 percent), significant valvular dysfunctions in 30 patients (29.1 percent), left ventricular systolic dysfunction in 10 patients (9.7 percent), and coronary arterial lesions in 27 patients (26.2 percent). In the control group, significant pericardial effusion was present in only one patient (2.5 percent). The number of patients with any one of echocardiographic abnormalities was 57 (55.3 percent) in Kawasaki group and one (2.5 percent) in control group. The sensitivity of echocardiography in the diagnosis of KD was 55.3 percent, the specificity 97.5 percent, the positive predictive value 98.3 percent, and the negative predictive value 45.9 percent.
Conclusion
: If abnormal echocardiographic findings, even if other than coronary arterial lesions, are confirmed in patients in whom KD is suspected, it seems desirable to inifiate specific treatment for KD.
Key Words: Kawasaki disease , Echocardiography


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