Clinical aspects for differential diagnosis of Kawasaki disease shock syndrome: a case control study
Abstract Background Because of the absence of a specific diagnostic test and pathognomonic clinical features, physicians must rely on the presence of specific clinical criteria and laboratory data that support the diagnosis of KD. To help clinicians distinguish KD, KDSS, septic shock, and TSS earlie...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-01-01
|
| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-020-02488-w |
| _version_ | 1818419204292870144 |
|---|---|
| author | Woo Young Park Sang Yun Lee Gi Beom Kim Mi Kyoung Song Hye Won Kwon Eun Jung Bae Eun hwa Choi June Dong Park |
| author_facet | Woo Young Park Sang Yun Lee Gi Beom Kim Mi Kyoung Song Hye Won Kwon Eun Jung Bae Eun hwa Choi June Dong Park |
| author_sort | Woo Young Park |
| collection | DOAJ |
| description | Abstract Background Because of the absence of a specific diagnostic test and pathognomonic clinical features, physicians must rely on the presence of specific clinical criteria and laboratory data that support the diagnosis of KD. To help clinicians distinguish KD, KDSS, septic shock, and TSS earlier, we suggest differential diagnosis and treatment guideline. Methods Medical records of immunocompetent patients who were admitted to the pediatric department with a diagnosis of KDSS, septic shock or TSS (SS group) were retrospectively reviewed. In addition, KD patients were selected by seasonal matching to each case of KDSS patient by date of admission (± 2 weeks). Results There were 13 patients with KDSS, 35 patients with SS group, and 91 patients with KD. In comparison between KDSS and septic shock group, KDSS group had significantly higher rate of coronary aneurysm incidence, and higher left ventricle dysfunction rate. In comparison between KDSS and TSS, patients with KDSS had a significantly higher erythrocyte sedimentation rate (ESR) and significantly lower creatinine. Receiver operation characteristic curve revealed that the optimal ESR cut off value for determining the KDSS was 56.0 (sensitivity 75.0%, specificity of 100.0%) and the optimal creatinine cut off value for determining the TSS was 0.695 (sensitivity 76.9%, specificity 84.6%). Conclusions Clinical symptoms, laboratory finding, echocardiography, and culture studies can be used to differentiate KD, KDSS, septic shock and TSS. |
| first_indexed | 2024-12-14T12:34:51Z |
| format | Article |
| id | doaj.art-57bc70d6fe224ee89f34b63d1734af7c |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-14T12:34:51Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-57bc70d6fe224ee89f34b63d1734af7c2022-12-21T23:01:05ZengBMCBMC Pediatrics1471-24312021-01-012111910.1186/s12887-020-02488-wClinical aspects for differential diagnosis of Kawasaki disease shock syndrome: a case control studyWoo Young Park0Sang Yun Lee1Gi Beom Kim2Mi Kyoung Song3Hye Won Kwon4Eun Jung Bae5Eun hwa Choi6June Dong Park7Department of Pediatrics, Seoul National University Children’s HospitalDepartment of Pediatrics, Seoul National University Children’s HospitalDepartment of Pediatrics, Seoul National University Children’s HospitalDepartment of Pediatrics, Seoul National University Children’s HospitalDepartment of Pediatrics, Seoul National University Children’s HospitalDepartment of Pediatrics, Seoul National University Children’s HospitalDepartment of Pediatrics, Seoul National University Children’s HospitalDepartment of Pediatrics, Seoul National University Children’s HospitalAbstract Background Because of the absence of a specific diagnostic test and pathognomonic clinical features, physicians must rely on the presence of specific clinical criteria and laboratory data that support the diagnosis of KD. To help clinicians distinguish KD, KDSS, septic shock, and TSS earlier, we suggest differential diagnosis and treatment guideline. Methods Medical records of immunocompetent patients who were admitted to the pediatric department with a diagnosis of KDSS, septic shock or TSS (SS group) were retrospectively reviewed. In addition, KD patients were selected by seasonal matching to each case of KDSS patient by date of admission (± 2 weeks). Results There were 13 patients with KDSS, 35 patients with SS group, and 91 patients with KD. In comparison between KDSS and septic shock group, KDSS group had significantly higher rate of coronary aneurysm incidence, and higher left ventricle dysfunction rate. In comparison between KDSS and TSS, patients with KDSS had a significantly higher erythrocyte sedimentation rate (ESR) and significantly lower creatinine. Receiver operation characteristic curve revealed that the optimal ESR cut off value for determining the KDSS was 56.0 (sensitivity 75.0%, specificity of 100.0%) and the optimal creatinine cut off value for determining the TSS was 0.695 (sensitivity 76.9%, specificity 84.6%). Conclusions Clinical symptoms, laboratory finding, echocardiography, and culture studies can be used to differentiate KD, KDSS, septic shock and TSS.https://doi.org/10.1186/s12887-020-02488-wKawasaki disease shock syndromeKawasaki diseaseSeptic shockToxic shock syndrome |
| spellingShingle | Woo Young Park Sang Yun Lee Gi Beom Kim Mi Kyoung Song Hye Won Kwon Eun Jung Bae Eun hwa Choi June Dong Park Clinical aspects for differential diagnosis of Kawasaki disease shock syndrome: a case control study BMC Pediatrics Kawasaki disease shock syndrome Kawasaki disease Septic shock Toxic shock syndrome |
| title | Clinical aspects for differential diagnosis of Kawasaki disease shock syndrome: a case control study |
| title_full | Clinical aspects for differential diagnosis of Kawasaki disease shock syndrome: a case control study |
| title_fullStr | Clinical aspects for differential diagnosis of Kawasaki disease shock syndrome: a case control study |
| title_full_unstemmed | Clinical aspects for differential diagnosis of Kawasaki disease shock syndrome: a case control study |
| title_short | Clinical aspects for differential diagnosis of Kawasaki disease shock syndrome: a case control study |
| title_sort | clinical aspects for differential diagnosis of kawasaki disease shock syndrome a case control study |
| topic | Kawasaki disease shock syndrome Kawasaki disease Septic shock Toxic shock syndrome |
| url | https://doi.org/10.1186/s12887-020-02488-w |
| work_keys_str_mv | AT wooyoungpark clinicalaspectsfordifferentialdiagnosisofkawasakidiseaseshocksyndromeacasecontrolstudy AT sangyunlee clinicalaspectsfordifferentialdiagnosisofkawasakidiseaseshocksyndromeacasecontrolstudy AT gibeomkim clinicalaspectsfordifferentialdiagnosisofkawasakidiseaseshocksyndromeacasecontrolstudy AT mikyoungsong clinicalaspectsfordifferentialdiagnosisofkawasakidiseaseshocksyndromeacasecontrolstudy AT hyewonkwon clinicalaspectsfordifferentialdiagnosisofkawasakidiseaseshocksyndromeacasecontrolstudy AT eunjungbae clinicalaspectsfordifferentialdiagnosisofkawasakidiseaseshocksyndromeacasecontrolstudy AT eunhwachoi clinicalaspectsfordifferentialdiagnosisofkawasakidiseaseshocksyndromeacasecontrolstudy AT junedongpark clinicalaspectsfordifferentialdiagnosisofkawasakidiseaseshocksyndromeacasecontrolstudy |