Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
권호 표지
DOI QR코드

DOI QR Code

Associated Symptoms of Kawasaki Disease

  • Yun, Sang-Hyun (Department of Pediatrics, Presbyterian Medical Center) ;
  • Yang, Nu-Ri (Department of Pediatrics, Presbyterian Medical Center) ;
  • Park, Sin-Ae (Department of Pediatrics, Presbyterian Medical Center)
  • Published : 2011.07.30
⟨ Previous Next ⟩

Abstract

Background and Objectives: In addition to diagnostic criteria, a broad range of nonspecific clinical features can be found in patients with Kawasaki disease. This lack of specificity may cause confusion with other febrile illnesses and delay the diagnosis of Kawasaki disease. The purpose of this study is to describe common associated symptoms and their clinical significances in children affected with Kawasaki disease. Subjects and Methods: As a retrospective study, we reviewed the medical records of 121 children who were treated for Kawasaki disease at Presbyterian medical center from January 2005 to June 2010. All clinical symptoms, laboratory data and echocardiographic findings in patients with KD were collected and analyzed. Results: We found that there are 9 associated symptoms, namely cough, rhinorrhea, sputum, abdominal pain, vomiting, diarrhea, arthralgia, headache and seizure, which occur in patients with Kawasaki disease. Among the study group, there were only 32 children with no associated symptoms (26.4%). Patients with abdominal pain and headache had an older mean age than those without such symptoms. The incidence of seizure was significantly higher in incomplete Kawasaki disease patients compared with those with complete Kawasaki disease. Vomiting was highly associated with IVIG non-responder group. Conclusion: To decrease the incidence of serious coronary complications due to delayed diagnosis, physicians need to be aware of the manifestations of Kawasaki disease and the possibility of associated symptoms, which, being unspecific, may otherwise not raise any red flags.

Keywords

References

  1. Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Jpn J Allergy 1967;16:178-222.
  2. Burns JC, Glodé MP. Kawasaki syndrome. Lancet 2004;364:533-44. https://doi.org/10.1016/S0140-6736(04)16814-1
  3. Kato H, Sugimura T, Akagi T, et al. Long-term consequences of Kawasaki disease: a 10- to 21-year follow-up study of 594 patients. Circulation 1996;94:1379-85. https://doi.org/10.1161/01.CIR.94.6.1379
  4. Dajani AS, Taubert KA, Gerber MA, et al. Diagnosis and therapy of Kawasaki disease in children. Circulation 1993;87:1776-80. https://doi.org/10.1161/01.CIR.87.5.1776
  5. Lee SY, Gwon HC, Park SW, et al. Acute myocardial infarction in young patient probably due to Kawasaki disease. Korean Circ J 2001;31:119-24.
  6. Newburger JW, Takahashi M, Burns JC, et al. The treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med 1986; 315:341-7. https://doi.org/10.1056/NEJM198608073150601
  7. Newburger JW, Takahashi M, Beiser AS, et al. A single intravenous infusion of gamma globulin as compared with four infusions in the treatment of acute Kawasaki syndrome. N Engl J Med 1991;324:1633-9. https://doi.org/10.1056/NEJM199106063242305
  8. Terai M, Shulman ST. Prevalence of coronary artery abnormalities in Kawasaki disease is highly dependent on gamma globulin dose but independent of salicylate dose. J Pediatr 1997;131:888-93. https://doi.org/10.1016/S0022-3476(97)70038-6
  9. Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004;110:2747-71. https://doi.org/10.1161/01.CIR.0000145143.19711.78
  10. Research Committe on Kawasaki Disease. Report of Subcommittee on Standardization of Diagnostic Criteria and Reporting of Coronary Artery Lesions in Kawasaki Disease. Tokyo, Japan: Ministry of Health and welfare;1984.
  11. Ayusawa M, Sonobe T, Uemura S, et al. Revision of diagnostic guidelines for Kawasaki disease (the 5th revised edition). Pediatr Int 2005;47: 232-4. https://doi.org/10.1111/j.1442-200x.2005.02033.x
  12. Nakano H, Ueda K, Saito A, Nojima K. Repeated quantitative angiograms in coronary arterial aneurysm in Kawasaki disease. Am J Cardiol 1985;56:846-51. https://doi.org/10.1016/0002-9149(85)90767-2
  13. Do HJ, Baek JG, Kim HJ, et al. Kawasaki disease presenting as parotitis in a 3-month-old infant. Korean Circ J 2009;39:502-4. https://doi.org/10.4070/kcj.2009.39.11.502
  14. Hicks RV, Melish ME. Kawasaki syndrome. Pediatr Clin North Am 1986;33:1151-75. https://doi.org/10.1016/S0031-3955(16)36113-2
  15. Melish ME, Hicks RV. Kawasaki syndrome: clinical features. Pathophysiology, etiology and therapy. J Rheumatol Suppl 1990;24:2-10.
  16. Park EY, Kim JH, Kim HS, Sohn SJ. Clinical features of Kawasaki disease in school-aged children. Korean J Pediatr 2007;50:292-7. https://doi.org/10.3345/kjp.2007.50.3.292
  17. Cho EY, Eun BW, Kim NH, et al. Association between Kawasaki disease and acute respiratory viral infections. Korean J Pediatr 2009; 52:1241-8. https://doi.org/10.3345/kjp.2009.52.11.1241
  18. Baker AL, Lu M, Minich LL, et al. Associated symptoms in the ten days before diagnosis of Kawasaki disease. J Pediatr 2009;154:592-5. https://doi.org/10.1016/j.jpeds.2008.10.006

Cited by

  1. The clinical profile of Kawasaki disease of children from three Polish centers: a retrospective study vol.34, pp.6, 2014, https://doi.org/10.1007/s00296-013-2836-7
  2. Abdominal lymphadenopathy in an adolescent with Kawasaki disease: a major sign? vol.29, pp.6, 2011, https://doi.org/10.1515/ijamh-2016-0028
  3. Abdominal lymphadenopathy in an adolescent with Kawasaki disease: a major sign? vol.29, pp.6, 2011, https://doi.org/10.1515/ijamh-2016-0028
  4. Clinical aspects of splenomegaly as a possible predictive factor of coronary artery changes in Kawasaki disease vol.29, pp.3, 2011, https://doi.org/10.1017/s1047951118002238
  5. Gastrointestinal Manifestations in Children with Kawasaki Disease in Isfahan, Iran vol.8, pp.2, 2020, https://doi.org/10.5812/pedinfect.103072
  6. Multisystem Inflammatory Syndrome in Children During the Coronavirus 2019 Pandemic: A Case Series vol.9, pp.3, 2011, https://doi.org/10.1093/jpids/piaa069
  7. Diagnosis and management of Kawasaki disease vol.63, pp.7, 2011, https://doi.org/10.5124/jkma.2020.63.7.374
  8. Kawasaki disease presenting with hoarseness: A multinational study of the REKAMLATINA network vol.63, pp.6, 2021, https://doi.org/10.1111/ped.14521