All issues > Volume 45(3); 2002

Original Article

J Korean Pediatr Soc. 2002;45(3):376-382. Published online March 15, 2002.

Clinical Features of Atypical Kawasaki Disease

Mi Young MY Heo¹, Su Jung SJ Choi¹, Hae Soon HS Kim¹, Sejung SJ Sohn¹

¹Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea

Correspondence Sejung SJ Sohn ,Email: sohn@ewha.ac.kr

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.

Keywords :Atypical Kawasaki disease