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November 1990

Diagnostic Guidelines for Kawasaki Disease

Am J Dis Child. 1990;144(11):1218-1219. doi:10.1001/archpedi.1990.02150350050022

Kawasaki disease, or mucocutaneous lymph node syndrome, is a disease of unknown origin that most frequently (80% of the time) affects infants and children under 5 years of age. Accurate diagnosis and early therapeutic interventions, such as aspirin and intravenous γ-globulin can decrease the approximately 20% risk of developing coronary artery abnormalities. A specific diagnostic test does not exist. Thus, diagnosis of Kawasaki disease is based on characteristic clinical signs and symptoms, which are classified as principal clinical findings and other significant findings. The male-to-female ratio among patients with Kawasaki disease is 1.5:1. Children of nearly all racial backgrounds are affected. Recurrences and cases in siblings are seen only occasionally.

PRINCIPAL CLINICAL FINDINGS  These include fever persisting at least 5 days and the following other principal features: (1) changes in peripheral extremities, including acute, ie, erythema and edema of hands and feet, and convalescent, ie, membranous desquamation of fingertips; (2)

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