Korean J Pediatr.  2015 Oct;58(10):374-379. 10.3345/kjp.2015.58.10.374.

Uveitis as an important ocular sign to help early diagnosis in Kawasaki disease

• Choi HS
• Lee SB
• Kwon JH
• Kim HS
• Sohn S
• Hong YM

• KMID: 2085445
• DOI: http://doi.org/10.3345/kjp.2015.58.10.374

Abstract

PURPOSE
Incomplete Kawasaki disease (KD) is frequently associated with delayed diagnosis and treatment. Delayed diagnosis leads to increasing risk of coronary artery aneurysm. Anterior uveitis is an important ocular sign of KD. The purpose of this study was to assess differences in laboratory findings, including echocardiographic measurements, clinical characteristics such as fever duration and treatment responses between KD patients with and those without uveitis.
METHODS
We conducted a prospective study with 110 KD patients from January 2008 to June 2013. The study group (n=32, KD with uveitis) was compared with the control group (n=78, KD without uveitis). Laboratory data were obtained from each patient including complete blood count (CBC), erythrocyte sedimentation rate (ESR), platelet count, and level of alanine aminotransferase, aspartate aminotransferase, serum total protein, albumin, C-reactive protein (CRP), and N-terminal probrain natriuretic peptide (NT-pro BNP). Echocardiographic measurements and intravenous immunoglobulin responses were compared between the two groups.
RESULTS
The incidence of uveitis was 29.0%. Neutrophil counts and patient age were higher in the uveitis group than in the control group. ESR and CRP level were slightly increased in the uveitis group compared with the control group, but the difference between the two groups was not significant. No significant differences in coronary arterial complication and treatment responses were observed between the two groups.
CONCLUSION
Uveitis is an important ocular sign in the diagnosis of incomplete KD. It is significantly associated with patient age and neutrophil count.

Keyword

Kawasaki disease; Uveitis; Brain natriuretic peptide

MeSH Terms

Alanine Transaminase
Aneurysm
Aspartate Aminotransferases
Blood Cell Count
Blood Sedimentation
C-Reactive Protein
Coronary Vessels
Delayed Diagnosis
Diagnosis
Early Diagnosis*
Echocardiography
Fever
Humans
Immunoglobulins
Incidence
Mucocutaneous Lymph Node Syndrome*
Natriuretic Peptide, Brain
Neutrophils
Platelet Count
Prospective Studies
Uveitis*
Uveitis, Anterior
Alanine Transaminase
Aspartate Aminotransferases
C-Reactive Protein
Immunoglobulins
Natriuretic Peptide, Brain