Associated symptoms in the ten days before diagnosis of Kawasaki disease.
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).


METHODS
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.
Baker
Annette L
AL
Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA. annette.baker@cardio.chboston.org
Lu
Minmin
M
Minich
L LuAnn
LL
Atz
Andrew M
AM
Klein
Gloria L
GL
Korsin
Rosalind
R
Lambert
Linda
L
Li
Jennifer S
JS
Mason
Wilbert
W
Radojewski
Elizabeth
E
Vetter
Victoria L
VL
Newburger
Jane W
JW
D015746:Abdominal Pain / Q000453:epidemiology; D001066:Appetite; D018771:Arthralgia / Q000453:epidemiology; D003371:Cough / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology; D042241:Early Diagnosis; D006801:Humans; D007223:Infant; D007508:Irritable Mood; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D018908:Muscle Weakness / Q000453:epidemiology; D009656:North America / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012220:Rhinitis / Q000453:epidemiology; D014839:Vomiting / Q000453:epidemiology