Sir.—Kawasaki disease may be associated with a variety of hematologic abnormalities, the most characteristic being thrombocytosis.1 Thrombocytopenia, in contrast, appears to occur rarely in children with this disease. In a recent study of 486 Japanese children with Kawasaki disease, Hara et al2 observed that 2% manifested thrombocytopenia early in their illness. To our knowledge, early thrombocytopenia has not been reported in other populations. We report the case of a child with Kawasaki disease who manifested thrombocytopenia during the first week of her illness.
Patient Report.—A 33-month-old white female child developed fever, diarrhea, and vomiting 4 days prior to admission followed 2 days later by the appearance of an erythematous eruption. On the day prior to admission, the child's pediatrician diagnosed staphylococcal or streptococcal scarlet fever and initiated treatment with dicloxacillin sodium. Throat, blood, and urine cultures obtained at this visit revealed no growth of bacterial pathogens.
KROWCHUK DP, KUMAR ML, VIELHABER MM, DANISH EH. Kawasaki Disease Presenting With Thrombocytopenia. Am J Dis Child. 1990;144(1):19-20. doi:10.1001/archpedi.1990.02150250021018