Cardiac Function in Kawasaki Disease Patients with Respiratory Symptoms

Lee, Seul Bee; Choi, Han Seul; Son, Sejung; Hong, Young Mi

KD with respiratory viruses is frequently misdiagnosed as a simple viral infection before other symptoms appear, so the diagnosis can be delayed. KD may be misdiagnosed as another febrile disease such as adenoviral infection, measles, rubella, and scarlet fever. 9) According to Ye et al. 24) NT-pro BNP had the highest diagnostic value for KD among other factors including cytokines, CRP, and ESR, which were recommended indexes by the American Heart Association. They found that NT-pro BNP is a reliable marker for the diagnosis of KD and the prediction of IVIG treatment effect. Dahdah et al. 25) reported that NT-pro BNP level was significantly higher in incomplete KD groups than in febrile patients (p<0.05). NT-pro BNP was a useful marker for the diagnosis of KD in patients less than 3 months of age. 26) Our study demonstrated that NT-pro BNP is a valuable diagnostic tool in differentiating KD from other febrile Table 2 ). The clinical manifestations of adenovirus, especially conjunctival injection, throat injection and prolonged fever, are somewhat like those of KD. KD is frequently misdiagnosed as pharyngoconjunctival fever caused by adenovirus because of the clinical similarity of the two diseases, 10) so infusion of IVIG may be delayed. Jordan-Villegas et al. 12) has shown that 2.4% of KD patients had adenovirus in their respiratory tract, and 5 of 6 KD patients with concomitant adenovirus infection had incomplete KD. Although virus PCR shows higher sensitivity and detects a relatively low level of virus, viral quantification was not done in this study.