Associated Symptoms of Kawasaki Disease

Abstract

Background and ObjectivesIn addition to diagnostic criteria, a broad range of nonspecific clinical features can be found in patients with Kawasaki disease. This lack of specificity may cause confusion with other febrile illnesses and delay the diagnosis of Kawasaki disease. The purpose of this study is to describe common associated symptoms and their clinical significances in children affected with Kawasaki disease.Subjects and MethodsAs a retrospective study, we reviewed the medical records of 121 children who were treated for Kawasaki disease at Presbyterian medical center from January 2005 to June 2010. All clinical symptoms, laboratory data and echocardiographic findings in patients with KD were collected and analyzed.ResultsWe found that there are 9 associated symptoms, namely cough, rhinorrhea, sputum, abdominal pain, vomiting, diarrhea, arthralgia, headache and seizure, which occur in patients with Kawasaki disease. Among the study group, there were only 32 children with no associated symptoms (26.4%). Patients with abdominal pain and headache had an older mean age than those without such symptoms. The incidence of seizure was significantly higher in incomplete Kawasaki disease patients compared with those with complete Kawasaki disease. Vomiting was highly associated with IVIG non-responder group.ConclusionTo decrease the incidence of serious coronary complications due to delayed diagnosis, physicians need to be aware of the manifestations of Kawasaki disease and the possibility of associated symptoms, which, being unspecific, may otherwise not raise any red flags.

The clinical profile of Kawasaki disease of children from three Polish centers: a retrospective study

“…In our study, we found the following “nonclassical” symptoms of KD: cough, abdominal pain, vomiting, diarrhea, and arthralgia, which is similar to what was reported in the previous studies [14, 19]. …”

Diagnosis of Incomplete Kawasaki Disease in Infants Based on an Inflammation at the Bacille Calmette-Guérin Inoculation Site

“…In the study, incomplete KD was defined as the presence of ≤4 principal symptoms defined according to the Japanese diagnostic criteria1) (corresponding to ≤3 principal features of the AHA diagnostic criteria2)) regardless of whether the patient had coronary artery abnormalities; their incomplete presentation group included 271 children (1.2%) with only one or 2 principal symptoms 14). Currently, a diagnosis of incomplete KD might be performed in cases with fewer classical diagnostic criteria and several compatible clinical, laboratory, or echocardiographic findings, based on the exclusion of another febrile illness 15). The above-mentioned results of the survey by Sudo et al14) seem to reflect the current diagnosing practice for incomplete KD.…”

Clinical Profile of Kawasaki Disease (KD) in Children admitted at Dhaka Shishu Hospital

“…This distribution of clinical signs was reported that in the previous studies. 16,21 In our study as well, these changes were also less commonly observed in incomplete KD. In the present study gastrointestinal symptoms, sterile pyuria and arthralgia were found as non-classical signs which are consistent with the findings of Yun et al and Manlhiot et al who demonstrated abdominal pain, vomiting, diarrhea, and Majority of the children had raised WBC (75%), raised ESR (95%), increased platelet count (70%) and elevated CRP (75%).…”