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Kawasaki Disease Diagnostic Criteria

Calculators  Multiple body systems
Kawasaki Disease diagnostic criteria is practical tool to assess occurence of kawasaki disease in patients.
Fever for ≥5 days
10
Acute change in extremities
Erythema of palms and soles, or edema of hands and feet
1
Subacute change in extremities
Periungual peeling of fingers and toes in weeks 2 and 3
1
Polymorphous exanthem
1
Bilateral bulbar conjunctival injection without exudate
1
Changes in lips and oral cavity
Erythema, lips cracking, strawberry tongue, diffuse injection of oral/pharyngeal mucosae
1
Cervical lymphadenopathy
>1.5 cm diameter, usually unilateral
1
Coronary artery disease detected by 2D echo or coronary angiogram
1
Result:

Background

Measured Factor
kawasaki disease criteria
Measured Factor Disease
  • Kawasaki disease
Measured Factor Detail
Kawasaki disease criteria can really help to diagnose the kawasaki disease at early stage only provinding enough time for preventive therapy to start.
Speciality
Multi-Speciality
Body System
Multiple body systems
Measured Factor Low Impact
  • A score of 0 shows the negative result of Kawasaki disease in person
Measured Factor High Impact
  • If all criteria's are in positive then kawsaki disease is present.

Result Interpretation

Ranges Ranges
  • Critical High: If all criteira are marked in positive
  • Normal: 0
  • Normal Adult Male: 0%
  • Normal Adult Female: 0%
  • Normal Pediatric: 0
  • Normal Neonate Female: 0
  • Normal Geriatric Male: 0%
  • Normal Geriatric Female: 0%
Result High Conditions
  • Kawasaki disease
Test Limitations
10% of patients who develop coronary artery (CA) abnormalities fail to meet the criteria for KD | High radiation exposure during computerized tomography can be harmful therefore its application in children was rather limited
References: 3

Studies

Study Validation 1
The aim of this study was to develop and validate a novel decision tree-based clinical algorithm to distinguish Kawasaki disease (KD) from other pediatric febrile illnesses that share similar clinical characteristics. Clinical and lab data from 801 subjects with acute KD and 479 febrile control subjects was used to develop step-wise KD diagnostic algorithm combining linear-discriminant-analysis (LDA)-based model and tree-based algorithm. Using 2-step algorithm patients were divided into: KD group, FC and indeterminate group.  LDA model differentiated patients FC (276), indeterminate (247), and KD (757) subgroups while decision trees model further stratified indeterminate group into FC (103) and KD (58) subgroups. This 2 step algorithm had 96% sensitivity and 78.5 % specificity. This study concluded that addition of a decision tree step can increase sensitivity and specificity in KD/FC classification over LDA model when used alone.
References: 4
Study Validation 2
This prospective, demographic based study was conducted with the aim to evaluate whether determining clinical and laboratory patterns would lead to an algorithm for Kawasaki diseases (KD) diagnosis. This could help clinicians in differentiating KD from other similar diseases like febrile controls (FCs). A total 136 patients with KD and 121 with FCs were included in the study for validation using either clinical data, laboratory test results, or their combination. Patients were then divided into subgroups according to their KD score with low (FC diagnosis, negative predictive value >95%), intermediate, and high (KD diagnosis, positive predictive value >95%) scores. This study concludes that KD scoring tool with additional clinical parameters is an effective method to identify KD patients
References: 5
Study Validation 3
This comparative study was conducted with aim to compare the two dosage regimens intravenously administered immune globulin (IVIG). Patients with Kawasaki syndrome were selected based on the features which were changes in the oropharynx, including reddening and fissuring of the lips, nonexudative conjunctivitis, erythema of the palms and soles, rash, and cervical lymphadenopathy. Patients were then randomized to receive either IVIG at either 400 mg/kg daily for 4 days or I gm/kg as a single dose (22 patients). The presence of coronary artery aneurysms was calculated by means of two-dimensional echocardiography before after infusion. Results showed that there was no sign of aneurysms and 1mg/KG dose was more effective dose.
References: 6
Study Additional 1
This prospective study was studied in pediatrics younger than 5 years German Pediatric Surveillance Unit (ESPED) hospitals. Underreporting in case of KD has become a major concerns as this study showed Incidence of KD, corrected for underreporting, was 37%-44% in children younger than 5 years in ESPED. Diagnostic method including and echocardiographic criteria only. This study concludes that there are higher rates of under reporting of KD among children
References: 7
Study Additional 2
A survey was done on Kawasaki disease in the British Isles by active reporting based on all cases reported to the British Pediatric Surveillance Unit. This study was aimed to determine the high case fatality rate of Kawasaki. 163 patients were selected from which six (3.7%) died, Forty five children (28%) suffered cardiac complications, 149 children (93%) had echocardiography. Erythrocyte sedimentation rate, sex, and the number of diagnostic criteria were noted.  Patients received treatment either aspirin therapy or intravenous gammaglobulin (IVGG). This study concluded that IVGG was less effective in the treatment of British patients with Kawasaki disease when compared with the patients treated in the United States and Japan
References: 8

References

  1. Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004;110(17):2747-71
  2. Fung WP, Khoo OT. Non-specific ulcerative colitis in two Asian patients in Singapore. Singapore Med J. 1969;10(1):54-6.
  3. Sundel RP. Update on the treatment of Kawasaki disease in childhood. Curr Rheumatol Rep. 2002;4(6):474-
  4. Hao S, Jin B, Tan Z, Li Z, Ji J, Hu G et al. A classification tool for differentiation of Kawasaki disease from other febrile illnesses. The Journal of pediatrics. 2016;176:114-120.e8. doi:10.1016/j.jpeds.2016.05.060.
  5. Ling XB, Kanegaye JT, Ji J, Sihua Peng,Yuichiro Sato, Adriana Tremouletet al. Point-of-care differentiation of Kawasaki disease from other febrile illnesses. J Pediatr. 2013;162(1):183-188.e3.
  6. Barron KS, Murphy DJ, Silverman ED, Ruttenberg HD, Wright GB, Franklin W et al. Treatment of Kawasaki syndrome: a comparison of two dosage regimens of intravenously administered immune globulin. J Pediatr. 1990;117(4):638-44.
  7. Jakob A, Whelan J, Kordecki M, Berner R, Stiller B, Arnold R, et al. Kawasaki Disease in Germany: A Prospective, Population-based Study Adjusted for Underreporting. Pediatr Infect Dis J. 2016;35(2):129-34.
  8. Dhillon R, Newton L, Rudd PT, Hall SM. Management of Kawasaki disease in the British Isles. Archives of Disease in Childhood. 1993;69(6):631-638.