Clinical Study of Typical and Atypical Kawasaki Diseases

ABSTRACT

PURPOSE: Atypical patients of Kawasaki Disease (KD) are now discovered with increasing frequency. The goal of this study is to help diagnose and treat KD by comparing of clinical characteristics between typical and atypical KD. METHODS: We performed a retrospective analysis of 82 patients with typical or atypical KD from January 1993 to March 1997. RESULTS: Out of the 82 patients, 49 cases were diagnosed as having typical KD, while there were 33 cases of atypical KD. The mean age was 31.4 months and 25.5 months respectively. The rate of prevalence in the changes of extremities, polymorphous exanthema, and cervical lymphadenopathy was greater in typical KD than atypical KD. The number of patients with various combinations of the principal symptoms among the 33 atypical cases were 18. Mean duration of fever was 6.2 days in typical cases and 5.8 days in atypical cases. The most common clinical findings were cough and rhinorrhea in both groups and the most common disease was pneumonia CRP was significantly elevated in patients with typical KD than atypical cases. Coronary artery dilatations were confirmed by 2-D echo in 7 (19.4%) of 36 tested typical cases, while 2 (9.1%) of 22 tested atypical cases. Patients were treated with aspirin and high-doses of IV gamma-globulin. CONCLUSION: Atypical KD was characterized by the infrequent appearance of rash, cervical lymphadenopathy, changes of hands and feet. We thought that there wasn't a strong association between atypical KD and coronary involvement.