Associated Symptoms in the Ten Days Before Diagnosis of Kawasaki Disease
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). Patients with acute KD were enrolled between days 4 and 10 of illness at 8 centers between 2002 and 2004. We define...
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| Published in: | The Journal of pediatrics Vol. 154; no. 4; pp. 592 - 595.e2 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Maryland Heights, MO
Mosby, Inc
01.04.2009
Elsevier |
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| ISSN: | 0022-3476, 1097-6833, 1097-6833 |
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| Abstract | 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).
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 ≥10% of patients. Principal clinical criteria for KD were not included in this analysis.
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 ≥ 1 respiratory symptom (rhinorrhea or cough).
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. |
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| AbstractList | 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 ≥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 ≥ 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. 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).OBJECTIVETo 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).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.STUDY DESIGNPatients 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.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).RESULTSAmong 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).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.CONCLUSIONSNonspecific 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. 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). 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 ≥10% of patients. Principal clinical criteria for KD were not included in this analysis. 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 ≥ 1 respiratory symptom (rhinorrhea or cough). 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. 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). 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. 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). 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. |
| Author | Lu, Minmin Klein, Gloria L. Minich, L. LuAnn Korsin, Rosalind Li, Jennifer S. Mason, Wilbert Atz, Andrew M. Baker, Annette L. Lambert, Linda Newburger, Jane W. Radojewski, Elizabeth Vetter, Victoria L. |
| Author_xml | – sequence: 1 givenname: Annette L. surname: Baker fullname: Baker, Annette L. email: annette.baker@cardio.chboston.org organization: Children's Hospital Boston and Harvard Medical School, Boston, MA – sequence: 2 givenname: Minmin surname: Lu fullname: Lu, Minmin organization: New England Research Institutes, Watertown, MA – sequence: 3 givenname: L. LuAnn surname: Minich fullname: Minich, L. LuAnn organization: Primary Children's Medical Center, Salt Lake City, UT – sequence: 4 givenname: Andrew M. surname: Atz fullname: Atz, Andrew M. organization: Medical University of South Carolina, Charleston, SC – sequence: 5 givenname: Gloria L. surname: Klein fullname: Klein, Gloria L. organization: New England Research Institutes, Watertown, MA – sequence: 6 givenname: Rosalind surname: Korsin fullname: Korsin, Rosalind organization: Columbia University Medical Center, New York, NY – sequence: 7 givenname: Linda surname: Lambert fullname: Lambert, Linda organization: Primary Children's Medical Center, Salt Lake City, UT – sequence: 8 givenname: Jennifer S. surname: Li fullname: Li, Jennifer S. organization: Duke University Medical Center, Durham, NC – sequence: 9 givenname: Wilbert surname: Mason fullname: Mason, Wilbert organization: Children's Hospital of Los Angeles and University of Southern California, Los Angeles, CA – sequence: 10 givenname: Elizabeth surname: Radojewski fullname: Radojewski, Elizabeth organization: University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada – sequence: 11 givenname: Victoria L. surname: Vetter fullname: Vetter, Victoria L. organization: The Children's Hospital of Philadelphia, Philadelphia, PA – sequence: 12 givenname: Jane W. surname: Newburger fullname: Newburger, Jane W. organization: Children's Hospital Boston and Harvard Medical School, Boston, MA |
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| Keywords | IVIG KD IVMP ESR Kawasaki disease Intravenous immunoglobulin Erythrocyte sedimentation rate Intravenous methylprednisolone Vascular disease Kawasaki syndrome Immunopathology Pediatrics Symptomatology Vasculitis Systemic disease Autoimmune disease Cardiovascular disease Diagnosis |
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| References | Kawasaki (bib2) 1967; 16 Kim, Choi, Woo, Choi, Lee, Lee (bib7) 2007; 166 Newburger, Sleeper, McCrindle, Minich, Gersony, Vetter (bib9) 2007; 356 Kato, Sugimura, Akagi, Sato, Hashino, Maeno (bib4) 1996; 94 Newburger, Takahashi, Gerber, Gewitz, Tani, Burns (bib1) 2004; 110 Newburger, Takahashi, Burns, Beiser, Duffy, Glode (bib5) 1986; 315 Terai, Shulman (bib6) 1997; 131 Taubert, Rowley, Shulman (bib3) 1991; 119 Melish, Hicks (bib14) 1990; 24 Burns, Mason, Glode, Shulman, Melish, Meissner (bib12) 1991; 118 (bib10) 1984 Hicks, Melish (bib13) 1986; 33 Minich, Sleeper, Atz, McCrindle, Lu, Colan (bib8) 2007; 120 Benseler, McCrindle, Silverman, Tyrrell, Wong, Yeung (bib11) 2005; 116 Kato (10.1016/j.jpeds.2008.10.006_bib4) 1996; 94 Minich (10.1016/j.jpeds.2008.10.006_bib8) 2007; 120 Newburger (10.1016/j.jpeds.2008.10.006_bib1) 2004; 110 Hicks (10.1016/j.jpeds.2008.10.006_bib13) 1986; 33 Melish (10.1016/j.jpeds.2008.10.006_bib14) 1990; 24 Taubert (10.1016/j.jpeds.2008.10.006_bib3) 1991; 119 Terai (10.1016/j.jpeds.2008.10.006_bib6) 1997; 131 (10.1016/j.jpeds.2008.10.006_bib10) 1984 Kawasaki (10.1016/j.jpeds.2008.10.006_bib2) 1967; 16 Burns (10.1016/j.jpeds.2008.10.006_bib12) 1991; 118 Benseler (10.1016/j.jpeds.2008.10.006_bib11) 2005; 116 Newburger (10.1016/j.jpeds.2008.10.006_bib9) 2007; 356 Kim (10.1016/j.jpeds.2008.10.006_bib7) 2007; 166 Newburger (10.1016/j.jpeds.2008.10.006_bib5) 1986; 315 |
| References_xml | – volume: 33 start-page: 1151 year: 1986 end-page: 1175 ident: bib13 article-title: Kawasaki syndrome publication-title: Pediatr Clin North Am – volume: 16 start-page: 178 year: 1967 end-page: 222 ident: bib2 article-title: [Acute febrile mucocutaneous lymph node syndrome: clinical observations of 50 cases] publication-title: Arerugi – volume: 24 start-page: 2 year: 1990 end-page: 10 ident: bib14 article-title: Kawasaki syndrome: clinical features publication-title: J Rheumatol Suppl – volume: 116 start-page: e760 year: 2005 end-page: e766 ident: bib11 article-title: Infections and Kawasaki disease: implications for coronary artery outcome publication-title: Pediatr – volume: 94 start-page: 1379 year: 1996 end-page: 1385 ident: bib4 article-title: Long-term consequences of Kawasaki disease: a 10- to 21-year follow-up study of 594 patients publication-title: Circulation – volume: 119 start-page: 279 year: 1991 end-page: 282 ident: bib3 article-title: Nationwide survey of Kawasaki disease and acute rheumatic fever publication-title: J Pediatr – volume: 120 start-page: e1434 year: 2007 end-page: e1440 ident: bib8 article-title: Delayed diagnosis of Kawasaki disease: what are the risk factors? 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publication-title: Pediatr doi: 10.1542/peds.2007-0815 – volume: 119 start-page: 279 year: 1991 ident: 10.1016/j.jpeds.2008.10.006_bib3 article-title: Nationwide survey of Kawasaki disease and acute rheumatic fever publication-title: J Pediatr doi: 10.1016/S0022-3476(05)80742-5 |
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| Title | Associated Symptoms in the Ten Days Before Diagnosis of Kawasaki Disease |
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