Abstract 44: Uveitis As An Important Ocular Sign To Help Early Diagnosis In Kawasaki Disease

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Abstract

Purpose: Atypical or incomplete Kawasaki disease (KD) frequently leads to delay in diagnosis and treatment. Delayed diagnosis is associated with increased risk of coronary artery aneurysm. Anterior uveitis peaks about a week after the onset of fever. The purpose of this study was to assess the differences in laboratorial findings including echocardiographic measurements, clinical characteristics such as duration of fever and treatment responses between KD patients with and without uveitis.

Materials and Methods: 106 KD patients were studied from January 2008 to June 2013. Study group (n=28, KD with uveitis) was compared with control group (n=78, KD without uveitis). Laboratory data were obtained from each patients including complete blood count (CBC), erythrocyte sedimentation rate (ESR), platelet count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total protein, albumin, C-reactive protein (CRP), brain natriuretic peptide (BNP). Echocardiographic measurement and intravenous immunoglobulin responses were compared between two groups.

Result: The incidence of uveitis was 26.4%. Neutrophil counts were higher in the uveitis group compared with the control group (64.3±15.8(х103/mm3) vs. 54.4±19.3 (х103/mm3)). The age of patients was higher in the uveitis group compared with the control group (40.5±21.4 months vs. 33.4±29.3 months). ESR (43.3±27.2 mm/hr vs. 30.8±24.6 mm/hr) and CRP (8.1±6.1 mg/dL vs. 7.9±10.7mg/dL) were slightly increased in the uveitis group compared with the control group, but there was no significant difference between the two groups. Coronary artery diameter was slightly increased in the uveitis group but there was no significant difference between the two groups. There were no significant differences in duration of fever, BNP, coronary arterial complication and treatment responses between the two groups.

Conclusion: Uveitis is the one of the important ocular signs to diagnose incomplete KD. It is significantly associated with the patient’s age and neutrophil count but not with the other laboratory measurements, coronary arterial complication or treatment responses.

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