Dataset Information

Associated symptoms in the ten days before diagnosis of Kawasaki disease.

ABSTRACT:

Objective

To describe common associated symptoms within the 10 days before diagnosis in subjects enrolled in the Pediatric Heart Network's trial of steroid therapy in Kawasaki disease (KD).

Study design

Patients with acute KD were enrolled between days 4 and 10 of illness at 8 centers between 2002 and 2004. We defined common associated symptoms as those occurring in >or=10% of patients. Principal clinical criteria for KD were not included in this analysis.

Results

Among 198 patients, irritability was reported in 98 (50%), vomiting in 88 (44%), decreased food/fluid intake in 73 (37%), cough in 55 (28%), diarrhea in 52 (26%), rhinorrhea in 37 (19%), weakness in 37 (19%), abdominal pain in 35 (18%), and joint pain (arthralgia or arthritis) in 29 (15%). One or more gastrointestinal symptom (vomiting, diarrhea, or abdominal pain) was present in 120 patients (61%) and 69 patients (35%) had >or= 1 respiratory symptom (rhinorrhea or cough).

Conclusions

Nonspecific symptoms occur commonly in children with KD. To reduce delays in diagnosis, clinicians should be educated that such symptoms may comprise a significant component in the chief complaint.

SUBMITTER: Baker AL

PROVIDER: S-EPMC2745188 | biostudies-literature | 2009 Apr

REPOSITORIES: biostudies-literature

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Publications

Associated symptoms in the ten days before diagnosis of Kawasaki disease.

Baker Annette L AL Lu Minmin M Minich L LuAnn LL Atz Andrew M AM Klein Gloria L GL Korsin Rosalind R Lambert Linda L Li Jennifer S JS Mason Wilbert W Radojewski Elizabeth E Vetter Victoria L VL Newburger Jane W JW

The Journal of pediatrics 20081128 4

<h4>Objective</h4>To describe common associated symptoms within the 10 days before diagnosis in subjects enrolled in the Pediatric Heart Network's trial of steroid therapy in Kawasaki disease (KD).<h4>Study design</h4>Patients with acute KD were enrolled between days 4 and 10 of illness at 8 centers between 2002 and 2004. We defined common associated symptoms as those occurring in >or=10% of patients. Principal clinical criteria for KD were not included in this analysis.<h4>Results</h4>Among 198 ...[more]

PMID: 19038400

Similar Datasets

Project description:Background: Kawasaki disease (KD) is one of the most common vasculitis in childhood. Intravenous γ-immunoglobulin (IVIG) is recommended to be administrated within 10 days after fever onset. However, some patients didn't have IVIG therapies because of atypical disease presentations or spontaneous defervescence. We aimed to evaluate the coronary outcomes of the KD patients who didn't receive IVIG and had defervescence within 10 days. Methods: We retrospectively reviewed the KD patients in NTUCH between 2008 and 2015. The patients with a diagnosis of KD and had a febrile length between 5 and 10 days were enrolled. Days of fever, clinical symptoms, laboratory data at the acute stage, and series of coronary artery measurements within a minimum of 3 months after disease onset were recorded. Risk factors associated with coronary lesions 1 month after KD onset were also analyzed. Results: Two hundred ninety-three eligible KD patients were enrolled (Male: 55.1%, mean age of onset: 1.8 years old). Thirty-seven patients had spontaneous defervescence without IVIG treatment. The incidence of coronary aneurysms at the 4th week after disease onset was higher in spontaneously defervesced KD patients than those treated with IVIG (18.9% vs. 5.1%, p = 0.002). Interestingly, of the 238 KD patients without coronary lesions at their acute phase, percentages of emerging coronary aneurysms became significantly higher if they didn't have IVIG therapies due to spontaneous defervescence (4/31), compared with those who received IVIG (3/208). Further analysis showed the development of coronary lesions at 1 month after disease onset was associated with younger age (<12 months old, p = 0.024), and leukocytosis (WBC > 17,000/cumm, p = 0.031). Conclusions: 18.9% of KD patients with spontaneous defervescence had coronary aneurysms. Even without initial coronary lesions, such patients were still riskier to develop coronary aneurysms, compared with KD patients who received IVIG therapies. Such findings address the importance of refining the strategy for use of IVIG in the spontaneously defervesced KD patients within 10 days after fever onset, at least in those with age younger than 1 year and those with leukocytosis.

Dataset Information

Associated symptoms in the ten days before diagnosis of Kawasaki disease.

Objective

Study design

Results

Conclusions

Publications

Associated symptoms in the ten days before diagnosis of Kawasaki disease.

Similar Datasets

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