A Severe Form of Kawasaki Disease Presenting with Only Fever and Cervical Lymphadenopathy at Admission - 07/03/14
, Michiko Arata, MD c, Chihaya Koriyama, MD b, Kiminori Masuda, MD c, Yasuko Morita, MD c, Daisuke Hazeki, MD a, Kentaro Ueno, MD a, Taisuke Eguchi, MD a, Yoshifumi Kawano, MD a
Reprint requests: Dr Yuichi Nomura, Division of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8520 Japan.Abstract |
Objective |
To examine the characteristics of patients with Kawasaki disease (KD) presenting with only fever and cervical lymphadenopathy at admission.
Study design |
The laboratory and clinical findings of patients with definite KD presenting with only fever and cervical lymphadenopathy at admission (KDiL) were compared with those of all other patients with KD.
Results |
Sixteen patients with KDiL (8.6%) and 171 patients without KDiL were examined. The patients with KDiL were significantly older (KDiL/non-KDiL: 4.9±2.5/2.2±1.9 years) and admitted earlier (3.0±1.2/3.9±1.3 days of illness) than the patients without KDiL. They also showed significantly elevated white blood cell counts and C-reactive protein levels. Patients with KDiL were treated with the same dose of intravenous immunoglobulin as the patients without KDiL but were treated slightly later and had significantly higher frequency of additional intravenous immunoglobulin treatment (38%/10%) and coronary artery abnormalities (25%/5%). After adjustment for age, white blood cell count, and day of illness at admission or first intravenous immunoglobulin administration, the presence of KDiL significantly increased the risk of being a nonresponder to IVIG treatment or development of a coronary artery abnormality.
Conclusions |
KDiL indicates a severe form of KD associated with increased risks of additional intravenous immunoglobulin treatment and coronary artery abnormalities. Patients with KDiL may require heightened surveillance and more aggressive treatment.
Le texte complet de cet article est disponible en PDF.Mots-clés : CAA, CRP, IVIG, KD, KDiL, LKD, OR, Other-KD, WBC, 95% CI
Plan
| The authors declare no conflicts of interest. |
Vol 156 - N° 5
P. 786-791 - mai 2010 Retour au numéro
Article précédent
- Prevalence of Congenital Heart Disease at Live Birth in Taiwan
- Mei-Hwan Wu, Hui-Chi Chen, Chun-Wei Lu, Jou-Kou Wang, Shin-Chung Huang, San-Kuei Huang
- Urinary Cytokines and Renal Doppler Study in Kawasaki Disease
- Jing-Ming Wu, Yuan-Yow Chiou, Wen-Pin Hung, Nan-Tsing Chiu, Mei-Ju Chen, Jieh-Neng Wang
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?