Kawasaki disease with lymphadenopathy and fever as sole initial manifestations

Abstract

Although a delay in diagnosis and stronger inflammation were found in LKD patients, such differences did not have any significant effect on patients' outcomes as assessed by the frequency of IVIG administration and the presence of CALs.

Lymph-Node-First Presentation of Kawasaki Disease Compared with Bacterial Cervical Adenitis and Typical Kawasaki Disease

“…1, 9, 10 A Japanese comparison of 14 patients with NFKD and 24 patients with BCL 12 revealed that patients with NFKD, as in our study, were older and had higher CRP levels. In contrast, their patients with NFKD had higher WBC, ANC, and aspartate aminotransferase levels and lacked the relative anemia and thrombocytopenia which we observed.…”

“…Compared with those with typical KD, previously reported patients with NFKD 9, 10 and patients with KD with cervical adenopathy 3, 4 were older and ill longer prior to diagnosis and had higher CRP 9, 10 and ESR values. 3 In the largest previous series (16 patients with NFKD and 171 with typical KD), patients with NFKD more often required repeated administration of IVIG and had an increased risk of coronary artery lesions.…”

“…Previous reports have compared NFKD with typical KD. 9, 10 Others have described radiologic features 11 and laboratory values 12 that could distinguish NFKD from BCL. Our KD Research Center’s extensive database afforded the unique opportunity to describe and compare NFKD, typical KD, and BCL from a single center.…”

Age-related Differences in the Course of the Acute Phase Symptoms of Kawasaki Disease

“…Patients with Kd with cervical lymphadenopathy as their dominant initial presentation were shown to be older and diagnosed later than other patients. 13,14 two other case series also reported that, in these patients, diagnosis was made on an average of 8.2 days of illness. 20,21 Comparatively delayed diagnosis in such patients highlights difficulty in timely diagnosis.…”

“…Patients with Kd presenting with only fever and cervical lymphadenopathy are reported to be older than patients with other presentations. 13,14 incomplete Kd, by contrast, is more common in infants. 2,15 understanding these differences in clinical manifestation is particularly helpful to provide timely identification of patients with Kd.…”