Journal of the Korean Pediatric Society 2002;45(3):376-382.
Published online March 15, 2002.
Clinical Features of Atypical Kawasaki Disease
Mi Young Heo, Su Jung Choi, Hae Soon Kim, Sejung Sohn
Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
비정형 가와사키병의 임상 양상
허미영, 최수정, 김혜순, 손세정
이화여자대학교 의과대학 소아과학교실
Correspondence: 
Sejung Sohn, Email: sohn@ewha.ac.kr
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 ≥5 days+major criterion+≥2 minor criteria, or fever of ≥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.
Key Words: Atypical Kawasaki disease


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