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June 1990

The Platelet Count in Kawasaki Syndrome

Author Affiliations

Department of Pediatrics/Adolescent Medicine Division of Infectious Diseases
Department of Pediatrics/Adolescent Medicine Division of Ambulatory Pediatrics St Louis University School of Medicine 1465 S Grand Blvd St Louis, MO 63104

Am J Dis Child. 1990;144(6):617-618. doi:10.1001/archpedi.1990.02150300011003

Sir.—We read with interest the article by Krowchuk et al in the January 1990 issue of AJDC.1 The authors presented a child with purported Kawasaki syndrome who had the unusual, early finding of thrombocytopenia. It must be reiterated, however, that this is a syndrome whose diagnosis is clinical, supported by nonspecific laboratory data.2 Because the cause remains obscure, other diagnoses must be sought and excluded. Although no bacterial pathogens were isolated from this patient, leptospiral cultures were not obtained and serologic studies were not performed. The child's clinical, laboratory, and roentgenographic features, including hydrops of the gallbladder, were all compatible with the diagnosis of leptospirosis.3 Furthermore, thrombocytopenia is a common finding in leptospirosis, even without concurrent disseminated intravascular coagulation.4,5

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