Complete and incomplete Kawasaki disease: two sides of the same coin

We sought to determine differences in clinical presentation, treatment response and coronary artery outcomes between complete and incomplete KD. All patients treated for KD between January 1990 and April 2007 were reviewed. Patients were classified as having an incomplete presentation if presenting with fever ≥ 5 days and <4 "classic" KD clinical signs. A total of 955 patients were included. Incomplete clinical presentation was seen in 217 cases (23%). Patient's demographic, clinical and laboratory characteristics were similar between groups with few exceptions. Patients presenting with incomplete KD had a longer median interval from symptom onset to diagnosis (7 [4-17] versus 6 [6-13] days, p < 0.001) and were less likely to be treated with intravenous immunoglobulin (86% versus 96%, p < 0.001). No significant difference between groups were seen in regard to coronary artery abnormalities (incomplete 13% versus complete 11%, p = 0.58).

Complete and incomplete KD appear to be different sides of the same coin, differing only in the number of signs and symptoms at presentation. Similar laboratory findings and coronary artery outcomes between the two groups support this conclusion.