Kawasaki Disease: Sensitivity and Specificity

Introduction: Kawasaki disease is a difficult disease to diagnose. The diagnosis relies on a constellation of symptoms.

[The following is taken from review article by Burns and Glode cited below]

The diagnosis is confirmed by the presence of fever for at least 5 days and of four of the five criteria below, and by the lack of another known disease process to explain the illness.

The following is a review article on Kawasaki disease that includes an extensive differential diagnosis for each of the important symptoms in the constellation of findings that define Kawasaki disease: Burns JC, Glodé MP. "Kawasaki syndrome." 1: Lancet. 2004 Aug 7-13;364(9433):533-44. PMID: 18387169

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Autoimmune Pediatrics Vasculitis Tag this Diagnosis.

Differential Diagnoses include: Acute Streptococcal Pharyngitis

The sensitivity and specificity of findings for Kawasaki Disease are listed below. See the left navigation bar to change the display.

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Elevated ALT	18.1%	100%	>100 U/l Study: J Pediatr 1991 May;118(5):680-6. PMID 2019921
Anemia and Elevated ESR	54.4%	92.3%	Hb < -2 S.D. for age, ESR > 50mm/hr Study: J Pediatr 1991 May;118(5):680-6. PMID 2019921
Residence near Water	41.1%	85.7%	within 200 yards Study: J Pediatr 1991 May;118(5):680-6. PMID 2019921

Sensitive Findings

Finding	Sensitivity	Specificity	Comments, Study
Clinical Criteria	90%	54%	as above, fever for 5 days plus at least 4/5: Bilateral conjunctival injection Changes of the mucous membranes of the upper respiratory tract: injected pharynx; injected, fissured lips; strawberry tongue Polymorphous rash Changes of the extremities: peripheral oedema, peripheral erythema, periungual desquamation Cervical adenopathy Mimics (from the J Peds article) include measles and group A Strep Differential Diagnosis: Acute Streptococcal Pharyngitis Study: sens: Acta Paediatr 1994 Oct;83(10):1057-60. PMID 7841704 spec: J Pediatr 1991 May;118(5):680-6. PMID 2019921

Poorly Diagnostic Findings

Finding	Sensitivity	Specificity	Comments, Study
Elevated ESR	59.8%	82.8%	>60 mm/hr Study: J Pediatr 1991 May;118(5):680-6. PMID 2019921