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Good Positive Likelihood Ratio

Kawasaki Disease: Likelihood Ratios

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.

  • 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
  • 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

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    Tags: Autoimmune Pediatrics Vasculitis Tag this Diagnosis.

    Differential Diagnoses include: Acute Streptococcal Pharyngitis

    The likelihood ratios of findings for Kawasaki Disease are listed below. See the left navigation bar to change the display.

    Pre-Test Probability (Prevalence): %. Post-Test Probability (Predictive Value): %. Switch to display mode.
    **Note that calculating probabilities from more than one finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)
    Good Positive and Negative Likelihood Ratios
    FindingResult +LR-LR
    [ + ] Clinical Criteria + 0 - 20.2
    [ + ] Anemia and Elevated ESR + 0 - 7.10.5
    [ + ] Elevated ESR + 0 - 3.50.5
    Good Positive Likelihood Ratio
    FindingResult +LR-LR
    [ + ] Elevated ALT + 0 - inf0.8
    [ + ] Residence near Water + 0 - 2.90.7