Associated symptoms in the ten days before diagnosis of Kawasaki disease

J Pediatr. 2009 Apr;154(4):592-595.e2. doi: 10.1016/j.jpeds.2008.10.006. Epub 2008 Nov 28.

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.

Trial registration: ClinicalTrials.gov NCT00132080.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Abdominal Pain / epidemiology
  • Appetite
  • Arthralgia / epidemiology
  • Cough / epidemiology
  • Diarrhea / epidemiology
  • Early Diagnosis
  • Humans
  • Infant
  • Irritable Mood
  • Mucocutaneous Lymph Node Syndrome / diagnosis*
  • Mucocutaneous Lymph Node Syndrome / epidemiology*
  • Muscle Weakness / epidemiology
  • North America / epidemiology
  • Prevalence
  • Prospective Studies
  • Rhinitis / epidemiology
  • Vomiting / epidemiology

Associated data

  • ClinicalTrials.gov/NCT00132080