Kawasaki disease laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Kawasaki disease is diagnosed | Kawasaki disease is diagnosed by clinical presentation, although the laboratory findings are non-specific for the diagnosis of Kawasaki disease - normocytic [[anemia]], [[thrombocytosis]], with [[Platelet|platelets]] ≥ 450×10<sup>3</sup>/μL (after first week of acute disease), [[Leukocytosis|leucocytosis]] with [[white blood cell count]] ≥ 15,000/μL, elevated [[erythrocyte sedimentation rate]], elevated [[liver enzyme]] levels, [[hypoalbuminemia]] with ≥ 3.0g/dL, elevated [[c-reactive protein]], [[hyponatremia]] and sterile [[pyuria]] can be noted on laboratory investigations. | ||
== Laboratory Findings == | == Laboratory Findings == | ||
Although non specific for diagnosis | Although non-specific for diagnosis, the following laboratory findings are helpful in the diagnosis of Kawasaki disease:<ref name="McCrindleRowley2017">{{cite journal|last1=McCrindle|first1=Brian W.|last2=Rowley|first2=Anne H.|last3=Newburger|first3=Jane W.|last4=Burns|first4=Jane C.|last5=Bolger|first5=Anne F.|last6=Gewitz|first6=Michael|last7=Baker|first7=Annette L.|last8=Jackson|first8=Mary Anne|last9=Takahashi|first9=Masato|last10=Shah|first10=Pinak B.|last11=Kobayashi|first11=Tohru|last12=Wu|first12=Mei-Hwan|last13=Saji|first13=Tsutomu T.|last14=Pahl|first14=Elfriede|title=Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association|journal=Circulation|volume=135|issue=17|year=2017|pages=e927–e999|issn=0009-7322|doi=10.1161/CIR.0000000000000484}}</ref><ref name="pmid15574639">{{cite journal |vauthors=Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, Shulman ST, Bolger AF, Ferrieri P, Baltimore RS, Wilson WR, Baddour LM, Levison ME, Pallasch TJ, Falace DA, Taubert KA |title=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 |journal=Pediatrics |volume=114 |issue=6 |pages=1708–33 |date=December 2004 |pmid=15574639 |doi=10.1542/peds.2004-2182 |url=}}</ref><ref name="pmid15505111">{{cite journal |vauthors=Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, Shulman ST, Bolger AF, Ferrieri P, Baltimore RS, Wilson WR, Baddour LM, Levison ME, Pallasch TJ, Falace DA, Taubert KA |title=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 |journal=Circulation |volume=110 |issue=17 |pages=2747–71 |date=October 2004 |pmid=15505111 |doi=10.1161/01.CIR.0000145143.19711.78 |url=}}</ref> | ||
*[[Complete blood count]] (CBC) may reveal: | *[[Complete blood count]] (CBC) may reveal: | ||
**[[Normocytic anemia]] | **[[Normocytic anemia]] | ||
**[[Normochromic anemia]] | **[[Normochromic anemia]] | ||
**[[Thrombocytosis]] | **[[Thrombocytosis]] | ||
***[[Platelet|Platelets]] ≥ 450×10<sup>3</sup>/μL (450 × 10<sup>9</sup>/L) after first week and peaking | ***[[Platelet|Platelets]] ≥ 450×10<sup>3</sup>/μL (450 × 10<sup>9</sup>/L) after the first week and peaking to a mean of ≈700,000 per mm<sup>3</sup> and normalizing after 4-6 weeks of onset of acute episode of Kawasaki disease | ||
**[[Leukocytosis|Leucocytosis]] | **[[Leukocytosis|Leucocytosis]] | ||
***[[White blood cell count]] ≥ 15,000/μL (15.0 × 10<sup>9</sup>/L) | ***[[White blood cell count]] ≥ 15,000/μL (15.0 × 10<sup>9</sup>/L) | ||
*Elevated [[ | *Elevated [[erythrocyte sedimentation rate]] | ||
*Elevated [[ | *Elevated [[c-reactive protein]] | ||
*[[Liver function tests]] may reveal: | *[[Liver function tests]] may reveal: | ||
**Elevated [[liver enzyme]] levels | **Elevated [[liver enzyme]] levels | ||
**[[Hypoalbuminemia]] ≥ 3.0g/dL (30g/L) | **[[Hypoalbuminemia]] ≥ 3.0g/dL (30g/L) | ||
*[[ | *Electrolyte study may reveal [[hyponatremia]] | ||
* | *Urine analysis may demonstrate sterile [[pyuria]] | ||
==References== | ==References== | ||
Revision as of 21:01, 16 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Overview
Kawasaki disease is diagnosed by clinical presentation, although the laboratory findings are non-specific for the diagnosis of Kawasaki disease - normocytic anemia, thrombocytosis, with platelets ≥ 450×103/μL (after first week of acute disease), leucocytosis with white blood cell count ≥ 15,000/μL, elevated erythrocyte sedimentation rate, elevated liver enzyme levels, hypoalbuminemia with ≥ 3.0g/dL, elevated c-reactive protein, hyponatremia and sterile pyuria can be noted on laboratory investigations.
Laboratory Findings
Although non-specific for diagnosis, the following laboratory findings are helpful in the diagnosis of Kawasaki disease:[1][2][3]
- Complete blood count (CBC) may reveal:
- Normocytic anemia
- Normochromic anemia
- Thrombocytosis
- Platelets ≥ 450×103/μL (450 × 109/L) after the first week and peaking to a mean of ≈700,000 per mm3 and normalizing after 4-6 weeks of onset of acute episode of Kawasaki disease
- Leucocytosis
- White blood cell count ≥ 15,000/μL (15.0 × 109/L)
- Elevated erythrocyte sedimentation rate
- Elevated c-reactive protein
- Liver function tests may reveal:
- Elevated liver enzyme levels
- Hypoalbuminemia ≥ 3.0g/dL (30g/L)
- Electrolyte study may reveal hyponatremia
- Urine analysis may demonstrate sterile pyuria
References
- ↑ McCrindle, Brian W.; Rowley, Anne H.; Newburger, Jane W.; Burns, Jane C.; Bolger, Anne F.; Gewitz, Michael; Baker, Annette L.; Jackson, Mary Anne; Takahashi, Masato; Shah, Pinak B.; Kobayashi, Tohru; Wu, Mei-Hwan; Saji, Tsutomu T.; Pahl, Elfriede (2017). "Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association". Circulation. 135 (17): e927–e999. doi:10.1161/CIR.0000000000000484. ISSN 0009-7322.
- ↑ Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, Shulman ST, Bolger AF, Ferrieri P, Baltimore RS, Wilson WR, Baddour LM, Levison ME, Pallasch TJ, Falace DA, Taubert KA (December 2004). "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". Pediatrics. 114 (6): 1708–33. doi:10.1542/peds.2004-2182. PMID 15574639.
- ↑ Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, Shulman ST, Bolger AF, Ferrieri P, Baltimore RS, Wilson WR, Baddour LM, Levison ME, Pallasch TJ, Falace DA, Taubert KA (October 2004). "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. 110 (17): 2747–71. doi:10.1161/01.CIR.0000145143.19711.78. PMID 15505111.