36 - IMPORTANCE OF PERIUNGUAL DESQUAMATION AND THROMBOCYTOSIS IN THE SUBACUTE PHASE OF KAWASAKI DISEASE

Background:

Periungual desquamation and thrombocytosis are characteristic of the subacute phase of Kawasaki disease (KD). However, accurate observation results of these are lacking.

Methods:

This retrospective study included patients with acute-phase KD who received treatment at seven affiliated university hospitals in Korea between 2015 and 2017. Data were extracted from an anonymized registry established by the Korean Society of Kawasaki Disease. We investigated whether the results of regular observation according to a set protocol until the subacute stage (Group I) showed different results compared to those that did not (Group II).

Results:

A total of 879 cases of KD were included in the analysis. Periungual desquamation was observed in 85% in Group I and 12.7% in Group II. Thrombocytosis was observed in 76.7% and 44.7%, respectively, and the increase in platelet count in consecutive tests compared to the test performed at the admission was 100% and 67.9%, respectively. When incomplete KD was defined only by the main symptoms of the acute stage, excluding periungual desquamation in the subacute stage, the significant difference in the incidence of incomplete Kawasaki disease between the two groups disappeared.

Conclusion:

After regular and detailed observation, the incidence of periungual detachment and thrombocytosis in the subacute phase of KD was higher than in recent studies. We suggest that regular monitoring of symptoms and signs in the subacute phase can help differentiate suspected cases of KD and allow for follow-up for complications.