Conjunctival changes in children with Kawasaki disease: cytopathologic characterization.
OBJECTIVE
To examine the cytopathological changes in the conjunctiva of patients with active Kawasaki disease.


METHODS
Case-control prospective study. Bilateral conjunctival swabs were obtained from 3 groups of children: patients with acute KD (11), age-matched controls (7), and patients with inactive KD (9). The ThinPrep prepared and Papanicolaou stained smears were examined blindly by 2 cytopathologists. The cell count differential of cells was performed and recorded quantitatively and comparisons between the 3 patient groups were made.


RESULTS
Only neutrophil counts showed a significant difference among the 3 groups. The average scores for the acute KD, control group, and patients with inactive KD were 3.5, 1.6 and 1.3, respectively. Using the Pearson chi2 test, the difference between the acute KD and the inactive group was statistically significant for both eyes (right p = 0.049, left p = 0.004). Samples from acute KD patients were more cellular. Neutrophils surrounding conjunctival epithelial cells, or "neutrophilic rosetting", were seen in 4 (36%) cases of the active disease group but not in the other groups.


CONCLUSIONS
"Neutrophilic conjunctivitis" is characteristic in patients of acute KD that may be of value in the initial evaluation and subsequent follow-up of KD patients.
Al-Abbadi
Mousa A
MA
Department of Pathology, Wayne State University/Detroit Medical Center, Detroit 48201, USA. alabbadi@dmc.org
Abuhammour
Walid
W
Harahsheh
Ashraf
A
Abdel-Haq
Nahed M
NM
Hasan
Rashid A
RA
Saleh
Husain A
HA
D000208:Acute Disease; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva / Q000473:pathology*; D003229:Conjunctival Diseases / Q000473:pathology*; D004804:Eosinophils / Q000473:pathology; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D009000:Monocytes / Q000473:pathology; D009080:Mucocutaneous Lymph Node Syndrome / Q000473:pathology*; D009504:Neutrophils / Q000473:pathology; D010950:Plasma Cells / Q000473:pathology; D011446:Prospective Studies