Kawasaki disease presenting with hoarseness: A multinational study of the REKAMLATINA network

Abstract

Background Recently, hoarseness affecting the supraglottic structure has been reported in Kawasaki disease (KD). The objective of this study was to characterize the frequency of hoarseness in acute KD patients in Latin America. Methods We used prospective data from the multinational Red de Enfermedad de Kawasaki en America Latina (REKAMLATINA) network. A total of 865 patients from 20 countries were enrolled during the 3 year study period. Data on hoarseness were available in 858 (99.2%) patients. The clinical and laboratory characteristics between hoarse and non‐hoarse KD were compared. Results Hoarseness was documented in 100 (11.6%) patients. Hoarse patients were younger than those with KD without hoarseness (median age 18 vs 26 months; P = 0.002) and presented with lower hemoglobin (10.7 g/dL vs 11.3 g/dL; P = 0.040) and hematocrit levels (32% vs 33%, P = 0.048). Conclusions Hoarseness was found to be prevalent as a presenting sign of acute KD in younger children. Anemia may indicate the presence of active inflammation.

Clinical features of Kawasaki disease initially mimicking retropharyngeal abscess: a retrospective analysis

“…However, there was no significant group difference, which was probably related to the small sample size. Previous studies revealed that hoarseness was found to be prevalent as a presenting sign of acute KD in younger children, it might be related to viral infection and immunological diseases, and hoarseness was presented in 11.6–30.0% patients [ 21 , 22 ]. However, in children with retropharyngeal abscess, hoarseness often be caused by compression of nerves by abscesses or inflammatory edema in the glottic region, the incidence of hoarseness was relatively low [ 23 , 24 ].…”

Global epidemiology of vasculitis

“…Intriguing aspects of Kawasaki disease epidemiology include the distinct global seasonality, with peaks in winter, spring and mid-summer, and the temporal and spatial clustering of cases 91 – 94 . No evidence exists to support person-to-person transmission of Kawasaki disease, and clinical features, including cervical lymphadenopathy, hoarseness and retropharyngeal oedema, all suggest a respiratory point of entry 95 – 97 . Potential clues to the aetiology of Kawasaki disease can be gleaned from the analysis of temporal clusters that share distinct clinical and laboratory features.…”