Journal of the Korean Pediatric Society 2001;44(12):1448-1453.
Published online December 15, 2001.
Clinical Analysis of Atypical Kawasaki Disease : Comparison of Kawasaki Disease Between Typical and Atypical Types
Eun Ju Jeong1, Jae Hong Park2, Hee Ju Park2
1Department of Pediatrics, Kwang Hye General Hospital, Pusan, Korea
2Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea
비정형 가와사끼병의 임상적 고찰 : 정형 가와사끼병과의 비교
정은주1, 박재홍2, 박희주2
1광혜병원 소아과
2부산대학교 의과대학 소아과학교실
Correspondence: 
Hee Ju Park, Email: phj@hyowon.pusan.ac.kr
Abstract
Purpose
: Kawasaki disease(KD) is known as one of the most important causes of acquired heart disease in children. But the incidence of acquired heart disease can be reduced by early diagnosis and treatment with large amounts of intravenous γ-globulin(IVGG). For early diagnosis and treatment of atypical KD, we analyzed and compared the clinical features, laboratory findings and coronary lesions in patients with typical or atypical KD.
Methods
: A retrospective chart review was conducted in all children with Kawasaki disease who were admitted to the Department of Pediatrics of Kwang-Hye Hospital between January 1998 and December 1999. Except for 15 cases who were not followed, 62 cases were involved in this study. We analyzed and compared the clinical features, laboratory findings and coronary lesions in patients with 39 typical cases and 23 atypical cases of KD.
Results
: The lowest incidence among clinical symptoms was cervical lymphadenopathy in both groups. In atypical cases, cervical lymphadenopathy, polymorphous exanthema, and changes of peripheral extremities were significantly lower than in typical cases. The duration of fever was similar in both groups, the mean defeverescence time after administration of IVGG in atypical cases was significantly shorter than typical cases(atypical, 2.6 days, typical cases, 1.8 days). The coronary artery dilatation appeared in 4 cases(17.4%) of atypical and 17 cases(43.6%) of the typical group. In most cases of both groups, left coronary artery dilatation was detected.
Conclusion
: To decrease the incidence of serious coronary complications due to atypical KD, careful evauation of clinical findings, early study of echocardiography and early infusion of large doses of IVGG are needed.
Key Words: Kawasaki disease, Atypical, Echocardiography


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