February 1995

Severe Thrombocytopenia as a Presenting Manifestation of Kawasaki Disease

Author Affiliations

Department of Pediatrics and Adolescent Medicine Tod Children's Hospital 500 Gypsy Ln Youngstown, OH 44501 Northeastern Ohio Universities College of Medicine 4209 State Route 44 Rootstown, OH 44272-0095

Arch Pediatr Adolesc Med. 1995;149(2):215-217. doi:10.1001/archpedi.1995.02170140097019

Kawasaki disease (KD) is an acute febrile illness of childhood that is characterized by conjunctival hyperemia, inflammation of the oral mucosa, characteristic changes in the extremities, cutaneous manifestations, and cervical adenopathy. The disease is most commonly seen in children younger than 5 years of age and is distinctly uncommon after adolescence.1

There is no diagnostic laboratory test for KD. However, elevated platelet counts are a consistent feature of this particular illness.2 Thrombocytosis was believed to be so central to the diagnosis that the presence of thrombocytopenia suggested an alternate diagnosis.3,4

Thrombocytopenia has been reported in KD.5-10 Twelve patients5-8 have had thrombocytopenia that was unassociated with idiopathic thrombocytopenic purpura. However, none of these individuals had a decrease in platelet count to a level that has been associated with spontaneous hemorrhage.11 Additionally, the thrombocytopenia was not the presenting manifestation. Three patients have been described with KD

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