Clinical Characteristics for Differentiating Febrile Children With Suspected Kawasaki Disease Diagnosis

• Main Authors: Jia-Huei Yan (Author), Ling-Sai Chang (Author), Yi-Ju Lin (Author), Mindy Ming-Huey Guo (Author), Ying-Hsien Huang (Author), Ho-Chang Kuo (Author)
• Format: Book
• Published: Frontiers Media S.A., 2020-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2296-2360; 10.3389/fped.2020.00221
• Keywords: clinical characteristics; febrile children; kawasaki disease; C-reactive protein; neutrophil-to-lymphocyte ratio; Pediatrics; RJ1-570
• Source: Frontiers in Pediatrics, Vol 8 (2020)

Background: Kawasaki disease (KD) is a form of vasculitis that primarily affects children under the age of 5 years old. Patients may be missed or diagnosis delayed when initial clinical symptoms do not fulfill the traditional criteria or a normal echocardiography was found. In this study, we aimed to analyze factors that clinicians could use to differentiate febrile children suspected of KD.Method: We retrospectively enrolled in this study a total of 50 febrile children who were initially suspected of KD, but they did not meet the American Heart Association (AHA) criteria for a diagnosis. However, some of these patients were diagnosed with KD during their second visit. We analyzed patients' characteristics, clinical symptoms, and laboratory data (initial data in the first visit).Results: In total, 50 patients were enrolled in the study. Of those, ten patients were diagnosed with KD on their second visit (group 1), while the other 40 patients still did not fit a KD diagnosis (group 2). A higher neutrophil-to-lymphocyte ratio (NLR, p = 0.037) and higher C-reactive protein levels (CRP, p = 0.02) were found in group 1 when compared to group 2. A patient with a NLR >1.33 combined with a CRP more than 33 mg/L was more likely to have KD (Sensitivity 90%, specificity 69.2%, p = 0.001; Odds ratio 20.25, 95% confident interval 2.3-178.25).Conclusion: Among patients suspected of KD that did not initially meet the criteria, clinicians should pay special attention to elevated neutrophil-to-lymphocyte ratios and CRP levels and closely follow up such patients.