Prediction of Coronary Artery Aneurysms in Typical and Atypical Kawasaki Disease(Papers for Cerebrating the Fifth Aniversary of the Directorship of Prof. M. Osawa at the Department of Pediatrics, Tokyo Women\u27s Medical University)

We reviewed 52 cases of Kawasaki disease that had been admitted to the Tokyo Women\u27s Medical University Hospital between January 1994 and August 1998. The clinical features of these cases were similar to the results of the 14th Nationwide Survey of Kawasaki Disease in Japan (1996). Recently we have seen some cases of atypical Kawasaki disease in which some of the major symptoms usually required for the diagnosis of typical Kawasaki disease were absent. In this report, we describe 5 atypical Kawasaki disease patients (9.6%) and 2 patients with coronary artery dilatation changes. In the atypical Kawasaki disease cases, there were less oropharyngeal changes and acute nonsuppurative cervical lymph adenopathy than is usually seen with typical Kawasaki disease, but there was an increased insidence of BCG redness. In the group with coronary artery dilatation changes, the Harada score at admission tended to rise after 3 days of treatment, which was frequent followed by a decrease in Ht, Alb values and increase in CRP values. In cases in which the Harada score was under 3 points, there were no coronary artery dilatation changes. The Harada score system is useful for deciding when to use intravenous γ globulin treatment. In cases of atypical Kawasaki disease, it is difficult to predict the risk of coronary artery aneurysm using laboratory data alone. Therefore these cases must be closely monitored by careful observation and frequent cardiacultrasonography examination to prevent coronary artery aneurysms.小児科学教室大澤真木子教授開講5周年記念特