J Korean Pediatr Soc.  2002 Mar;45(3):376-382.

Clinical Features of Atypical Kawasaki Disease

• Heo MY
• Choi SJ
• Kim HS
• Sohn SJ

Abstract

PURPOSE: To identify clinical and laboratory features of atypical Kawasaki disease(KD), and to develop criteria for early diagnosis of atypical KD patients.
METHODS
All patients with KD treated at our hospital from January 1998 to June 2000 were reviewed retrospectively.
RESULTS
Among a total of 167 patients, 28(16.8%) were atypical KD of which seven(25%) were infants. Among the five cardinal symptoms, oral mucosal change(96.4%) occurred most frequently, followed by conjuntivitis(57.1%) and rash(46.4%). Most notable laboratory findings were anemia, and increased erythrocyte sedementation rate(ESR) or C-reactive protein(CRP). Coronary artery abnormalities developed in seven(25.8%) atypical KD patients, compared with 14.4% in typical KD patients. We considered oral mucosal change as major criterion, and conjunctivitis, rash, hematocrit <35% and ESR >30 mm/hr or CRP >3.1 mg/dL as minor criteria. Proposed modification in diagnostic criteria for atypical KD include fever of >or=5 days;major criterion+>or=2 minor criteria, or fever of >or=5 days+4 minor criteria.
CONCLUSION
The modified diagnostic criteria has yielded a sensitivity 89.3%. Our diagnostic criteria may be used for early diagnosis of atypical KD.

Keyword

Atypical Kawasaki disease

MeSH Terms

Anemia
Conjunctivitis
Coronary Vessels
Early Diagnosis
Erythrocytes
Exanthema
Fever
Hematocrit
Humans
Infant
Mucocutaneous Lymph Node Syndrome*
Retrospective Studies