Diagnostics
CHI-NAN HUANG, n/a
Pediatric Cardiologist
Taipei City Hospital
Taipei City, Taiwan
Background:
This study focuses on Kawasaki disease (KD) in children presenting with fever and liver function abnormalities. KD, often diagnosed by clinical criteria including persistent fever and at least four out of five specific symptoms, sometimes manifests with non-specific gastrointestinal symptoms and liver panel abnormalities. The aim is to understand the presentation of KD in Taiwanese children, specifically looking at cases initially presenting with fever and liver dysfunction.
Methods:
The study retrospectively reviewed medical records from 2010 to 2019 at Taipei City Hospital, focusing on pediatric patients who were hospitalized with fever and liver function abnormalities. Data collected included patient characteristics, clinical presentation, laboratory findings, and final diagnosis.
Results:
Out of 157 pediatric patients meeting the criteria, the average age was 2.4 years, with varying degrees of fever duration and liver function abnormalities. 19 patients (12.1%) were diagnosed with KD. KD patients exhibited longer fever duration and significant elevations in ALT levels, but no statistical difference in age, hospital stay duration, other liver function tests, or gastrointestinal symptoms compared to non-KD patients. Using ALT analysis, the area under the curve was 0.772 with statistical significance less than 0.05. For a cut level of ALT greater than or equal to 74, the sensitivity for diagnosing KD in patients with fever and elevated ALT was 0.842, and specificity was 0.670.
Conclusion:
The study found that prolonged fever and elevated ALT levels in pediatric patients might suggest KD, even in the absence of typical KD symptoms. Early diagnosis and appropriate treatment are crucial for reducing cardiovascular complications. The presence of gastrointestinal symptoms did not significantly aid in KD diagnosis among hospitalized children with fever and liver function abnormalities.