dr Sujata Sawhney
Pediatric Rheumatologist

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1. Sterile pyuria Has been reported in up to 80% of children with KD and is useful in children with incomplete KD and as an adjunct investigation

2. Relevance of BCG Scar in Kawasaki Disease.

Erythema at the site of BCG inoculation is seen in up to 50% of young infants , especially males , is a specific sign of Kawasaki disease and can be used for early diagnosis. This phenomenon has been ascribed to cross-reactivity between mycobacterial heat shock protein (HSP) 65 and human homologue HSP 63. Do look at BCG scar site when suspecting KD.

3. Platelet increase late in Kawasaki Disease

The subacute phase of KD occurs about 10 to 25 days after the onset of fever. This phase is often characterized by periungual desquamation of the fingers and toes. The elevation of the platelet count also usually occurs after day 10 of illness. One should not wait for IVIG administration as it is most effective beforeday 10.

4. Normal CRP & not ESR indicates recovery after IVIG administration

The ESR is a measurement of red cell aggregation. Plasma fibrinogen, total globulin, and macroglobulins all enhance red cell aggregation and sedimentation rates. Hence, once the IVIG has been given, the ESR will measure high and no longer remains a reliable indicator of inflammation. The CRP remains independent of plasma viscosity and can be followed both before and after IVIG.

 



Posted On: 08/05/2018

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