The Journal of Pediatrics
Volume 156, Issue 5 , Pages 786-791 , May 2010

A Severe Form of Kawasaki Disease Presenting with Only Fever and Cervical Lymphadenopathy at Admission

  • Yuichi Nomura, MD

      Affiliations

    • Division of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences. Kagoshima, Japan
    • Corresponding Author InformationReprint requests: Dr Yuichi Nomura, Division of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8520 Japan.
    • ,
  • Michiko Arata, MD

      Affiliations

    • Department of Pediatrics, Kagoshima Medical Association Hospital, Kagoshima, Japan
    • ,
  • Chihaya Koriyama, MD

      Affiliations

    • Division of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences. Kagoshima, Japan
    • ,
  • Kiminori Masuda, MD

      Affiliations

    • Department of Pediatrics, Kagoshima Medical Association Hospital, Kagoshima, Japan
    • ,
  • Yasuko Morita, MD

      Affiliations

    • Department of Pediatrics, Kagoshima Medical Association Hospital, Kagoshima, Japan
    • ,
  • Daisuke Hazeki, MD

      Affiliations

    • Division of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences. Kagoshima, Japan
    • ,
  • Kentaro Ueno, MD

      Affiliations

    • Division of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences. Kagoshima, Japan
    • ,
  • Taisuke Eguchi, MD

      Affiliations

    • Division of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences. Kagoshima, Japan
    • ,
  • Yoshifumi Kawano, MD

      Affiliations

    • Division of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences. Kagoshima, Japan

Received 1 May 2009 ,Revised 12 October 2009 ,Accepted 13 November 2009.

References 

  1. Yanagawa H, Nakamura Y, Yashiro M, Uehara R, Oki I, Kayaba K. Incidence of Kawasaki disease in Japan: the nationwide surveys of 1999-2002. Pediatr Int. 2006;48:356–361
  2. Harada K. Intravenous gamma-globulin treatment in Kawasaki disease. Acta Pediatr Jpn. 1991;33:805–810
  3. Zhang T, Yanagawa H, Oki I, Nakamura Y, Yashiro M, Ojima T, et al. Factors related to cardiac sequelae of Kawasaki disease. Eur J Pediatr. 1999;158:694–697
  4. Nomura Y, Masuda K, Sameshima K, Yoshinaga M, Miyata K. Patients diagnosed as having Kawasaki syndrome within the 5th day of illness have a high risk of coronary artery aneurysm. Pediatr Int. 2002;44:353–357
  5. Muta H, Ishii M, Sakaue T, Egami K, Furui J, Sugahara Y, et al. Older age is a risk factor for the development of cardiovascular sequelae in Kawasaki disease. Pediatrics. 2004;114:751–754
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  7. Stamos JK, Corydon K, Donaldson J, Shulman ST. Lymphadenitis as the dominant manifestation of Kawasaki disease. Pediatrics. 1994;93:525–528
  8. Kao HT, Huang TC, Lin TY. Kawasaki disease presenting as cervical lymphadenitis or deep neck infection. Otolaryngol Head Neck Surg. 2001;124:468–470
  9. Ayusawa M, Sonobe T, Uemura S, Ogawa S, Nakamura Y, Kiyosawa N, et al. Revision of diagnostic guidelines for Kawasaki disease (5th revised edition). Pediatr Int. 2005;47:232–234
  10. Kurotobi S, Nagai T, Kawakami N, Sano T. Coronary diameter in normal infants, children and patients with Kawasaki disease. Pediatr Int. 2002;44:1–4
  11. Research Committee on Kawasaki Disease. Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Tokyo, Japan: Ministry of Health and Welfare; 1994;
  12. Egami K, Muta H, Ishii M, Suda K, Sugahara Y, Iemura M, et al. Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease. J Pediatr. 2006;149:23740
  13. Kobayashi T, Inoue Y, Takeuchi K, Okada Y, Tamura K, Tomomasa T, et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease. Circulation. 2006;113:2606–2612
  14. Fan PC, Chiu CH, Yen MH, Huang YC, Li CC, Lin TY. School-aged children with Kawasaki disease: high incidence of cervical lymphadenopathy and coronary artery involvement. J Paediatr Child Health. 2003;39:55–57
  15. Lee KY, Hong JH, Han JW, Lee JS, Lee BC, Burger D. Features of Kawasaki disease at the extreme of age. J Paediatr Child Health. 2006;42:423–427
  16. Kubota M, Usami I, Yamakawa M, Tomita Y, Haruta T. Kawasaki disease with lymphadenopathy and fever as sole initial manifestations. J Paediatr Child Health. 2008;44:359–362
  17. Tashiro N, Matsubara T, Uchida M, Katayana K, Ichiyama T, Furukawa S. Ultrasonographic evaluation of cervical lymph nodes in Kawasaki disease. Pediatrics. 2002;109:e77
  18. Yanagi S, Nomura Y, Masuda K, Koriyama C, Sameshima K, Eguchi T, et al. Early diagnosis of Kawasaki disease in patients with cervical lymphadenopathy. Pediatr Int. 2008;50:179–183

 The authors declare no conflicts of interest.

PII: S0022-3476(09)01151-2

doi: 10.1016/j.jpeds.2009.11.042

The Journal of Pediatrics
Volume 156, Issue 5 , Pages 786-791 , May 2010

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