Increased detection rate of Kawasaki disease using new diagnostic algorithm, including early use of echocardiography.
OBJECTIVE
To determine the incidence of Kawasaki disease (KD) in Northern France by using new American Heart Association (AHA) criteria.


METHODS
A 1-year prospective multicenter cohort study was performed in all pediatric departments. Patients <18 years old, who were admitted for prolonged but initially unexplained fever or suspected KD were included. All patients received the standard treatment considered appropriate by their physicians. A descriptive analysis and comparison of patients with complete and incomplete forms of KD were performed. The incidence of confirmed cases of KD (complete and incomplete forms) was calculated.


RESULTS
Seventy-seven children were included (39 in whom KD was diagnosed). Of the patients with KD, 26 (67%) met the classic AHA case definition, and 7 (18%) had incomplete KD. Cardiac ultrasound scanning was helpful in the diagnosis of 6 of 7 patients with incomplete KD (86%). The final incidence of confirmed KD was 9 of 100,000 children <5 years of age. In 6 children (15%) the diagnosis of KD was uncertain, but they were successfully treated for it. Coronary disease was identified in 48% of patients with confirmed KD.


CONCLUSIONS
The incidence of KD is higher than previously reported, in part because earlier reports did not include incomplete forms. New AHA criteria (laboratory tests and early echocardiography) were helpful for the diagnosis of incomplete forms of KD.
Heuclin
Thérèse
T
Lille University Hospital, Faculté de Médecine Henri Warembourg, Lille-2 University, Lille, France.
Dubos
François
F
Hue
Valérie
V
Godart
François
F
Francart
Charles
C
Vincent
Pascal
P
Martinot
Alain
A
D017677:Age Distribution; D000465:Algorithms; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods; D042241:Early Diagnosis; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution
D002097:C-Reactive Protein