Pediatr Infect Vaccine.  2016 Apr;23(1):10-17. 10.14776/piv.2016.23.1.10.

Comparison of Cervical-lymph-node-first Presentation of Kawasaki Disease and Typical Kawasaki Disease

• Yun HW
• Lee JY
• Yang SI
• Yu HJ
• Kang MJ
• Lee SY
• Lee HR
• Kim KN
• Kim SH

• KMID: 2163218
• DOI: http://doi.org/10.14776/piv.2016.23.1.10

Abstract

PURPOSE
The diagnosis of Kawasaki disease depends on clinical symptoms, which makes it difficult to diagnose early in patients with only cervical lymphadenopathy. The purpose of this study is to understand the clinical characteristics of cervical-lymph-node-first presentation of Kawasaki disease and compare them with those of typical Kawasaki disease.
METHODS
We surveyed 283 patients who were admitted to Hallym Sacred Heart Hospital and were diagnosed with Kawasaki disease from January 2012 to December 2014. The patients were divided into two groups: cervical-lymph-node-first presentation of Kawasaki disease (LKD, N=24) and typical Kawasaki disease (KD, N=259). The medical records were retrospectively reviewed.
RESULTS
The mean age of the LKD group was higher than that of the KD group (P=0.04). At admission, the LKD patients had on average 1.62 out of 5 symptoms, whereas the KD patients had 3.47. The time from fever to diagnosis and administration of IV immunoglobulin was longer in the LKD group than in the KD group (P<0.001). The mean C-reactive protein of the LKD group was higher than that of the KD group (P=0.01). There were no statistical differences in the presence of coronary artery complications between the two groups at two weeks or at two months after diagnosis (P=0.52, P=0.08).
CONCLUSIONS
The Kawasaki disease patients with fever and cervical lymphadenopathy usually do not present obvious clinical symptoms, which makes it hard to diagnose in the early phase of disease. Clinician must pay attention when examining these patients.

Keyword

Kawasaki disease; Cervical lymph node; Children

MeSH Terms

C-Reactive Protein
Child
Coronary Vessels
Diagnosis
Fever
Heart
Humans
Immunoglobulins
Lymphatic Diseases
Medical Records
Mucocutaneous Lymph Node Syndrome*
Retrospective Studies
C-Reactive Protein
Immunoglobulins

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