Fulfillment of diagnostic criteria in Kawasaki disease

Background. The diagnosis of Kawasaki disease (KD) is made by fulfillment o f clinical criteria. The dramatic effectiveness of intravenous immune globu lin in this disease might lead to treatment of cases that do not meet those criteria. Methods. A retrospective review was conducted of all cases of KD treated at Kosair Children's Hospital between January 1993 and July 1997. Results. Fifty-six patients were identified. Demographic features were simi lar to reports from other regions of the country. Forty-eight children fulf illed criteria for typical or atypical KD and 8 (14%) did not. The latter c hildren were not distinguished fr om those meeting criteria by standard lab oratory test results. Echocardiographic abnormalities were found in 17 case s, including 3 with coronary artery aneurysms, bur all abnormalities eventu ally resolved, Conclusions. The treatment of 14% of patients despite incomplete diagnostic criteria illustrates the tendency to be liberal in treatment decisions reg arding KD. Whether this proportion of patients has a forme fruste of the il lness that warrants treatment will await definitive biological markers for the syndrome.