Associated symptoms in the ten days before diagnosis of Kawasaki disease
Annette L Baker, Minmin Lu, L LuAnn Minich, Andrew M Atz, Gloria L Klein, Rosalind Korsin, Linda Lambert, Jennifer S Li, Wilbert Mason, Elizabeth Radojewski, Victoria L Vetter, Jane W Newburger, Pediatric Heart Network Investigators, D R Fulton, R P Sundel, S Colan, A L Woodward, F Dedeoglu, S Kim, R Fulhlbrigge, B Binstadt, M Takahashi, V Guerrero, A Hogart, S Paridon, J Rychik, M Harkins, W Gersony, L Imundo, D Levy, D Hsu, S Mital, P Anderson, A M Nawrocki, D Harrington, B W McCrindle, T Bradley, R Yeung, G Shirali, M Scheurer, A Jones, R V Williams, D U Frank, L Y Tani, A L Smart, L Sleeper, P Nash, D Gallagher, P D Mitchell, G D Pearson, V Pemberton, M Stylianou, J Massicot-Fisher, T Hoke, L Mahoney, Annette L Baker, Minmin Lu, L LuAnn Minich, Andrew M Atz, Gloria L Klein, Rosalind Korsin, Linda Lambert, Jennifer S Li, Wilbert Mason, Elizabeth Radojewski, Victoria L Vetter, Jane W Newburger, Pediatric Heart Network Investigators, D R Fulton, R P Sundel, S Colan, A L Woodward, F Dedeoglu, S Kim, R Fulhlbrigge, B Binstadt, M Takahashi, V Guerrero, A Hogart, S Paridon, J Rychik, M Harkins, W Gersony, L Imundo, D Levy, D Hsu, S Mital, P Anderson, A M Nawrocki, D Harrington, B W McCrindle, T Bradley, R Yeung, G Shirali, M Scheurer, A Jones, R V Williams, D U Frank, L Y Tani, A L Smart, L Sleeper, P Nash, D Gallagher, P D Mitchell, G D Pearson, V Pemberton, M Stylianou, J Massicot-Fisher, T Hoke, L Mahoney
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.
Source: PubMed