Incomplete Kawasaki disease

Causes and risk

90% of cases are under the age of 5, and there is an increased incidence in East Asian ethnicity.

How it is diagnosed

Complete Kawasaki disease is 5 or more days of fever with at least 4 of the following five classic clinical criteria: 1) bilateral bulbar nonsuppurative conjunctivitis, with perilimbal sparing; 2) oropharyngeal changes, that is pharyngeal erythema, dry fissured lips and a strawberry tongue; 3) cervical lymphadenopathy, unilateral, with at least one node over 1.5 cm in diameter; 4) extremity changes in the palms and soles, with erythema, nonpitting edema and periungual or generalized desquamation; 5) rash, erythematous, polymorphous and generalized, with confluent patches and plaques that vary in appearance.

Incomplete Kawasaki disease is diagnosed when there are 5 or more days of fever and at least 2 to 3 of those classic clinical criteria are met, with elevated inflammatory markers (CRP, ERS), together with either positive findings on echocardiography or at least 3 of the supplemental laboratory criteria.

The supplemental laboratory criteria are: 1) anemia; 2) thrombocytosis, a platelet count above 450, after 7 days of fever; 3) hypoalbuminemia; 4) elevated liver transaminases; 5) leukocytosis; and sterile pyuria.