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Discrimination of Kawasaki disease with concomitant adenoviral detection differentiating from isolated adenoviral

Jong Han Kim1, Hye Ree Kang1, Su Yeong Kim1

  • 1Department of Pediatrics, Hallym University Medical Center, Seoul, Korea.

Korean Journal of Pediatrics
|March 23, 2018
PubMed
Abstract

Insights

Adenovirus infection can mimic Kawasaki disease (KD). Lip/tongue changes, high C-reactive protein (CRP), and sterile pyuria help distinguish adenovirus-positive KD from isolated adenovirus infections.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Rheumatology

Background:

  • Human adenovirus infections can present similarly to Kawasaki disease (KD), a serious pediatric inflammatory condition.
  • Distinguishing between KD with adenovirus infection and isolated adenovirus infection is crucial for appropriate management.
  • Identifying predictive biomarkers can aid in early diagnosis and treatment of adenovirus-positive KD.

Purpose of the Study:

  • To delineate clinical and laboratory differences between KD with adenovirus infection and isolated adenovirus infection.
  • To identify biomarkers for predicting adenovirus-positive KD in patients presenting with adenoviral infection.

Main Methods:

  • Quantitative polymerase chain reaction (PCR) was used to identify 147 patients with isolated adenovirus infections.
  • Eleven patients diagnosed with KD and concurrent adenovirus infection, treated with intravenous immunoglobulin (IVIG), were evaluated.
  • Clinical features, laboratory parameters (including C-reactive protein - CRP), and sterile pyuria were analyzed.

Main Results:

  • The KD with adenovirus group showed significantly more lip/tongue changes, skin rash, and extremity changes compared to the isolated adenovirus group.
  • Higher CRP levels, hypoalbuminemia, and sterile pyuria were significantly associated with the KD group.
  • Multivariate analysis identified lip/tongue changes (OR 1.416), high CRP (OR 1.039), and sterile pyuria (OR 1.052) as significant predictors of KD. A CRP cutoff of 56 mg/L predicted KD with 81.8% sensitivity and 75.9% specificity.

Conclusions:

  • Lip and tongue changes, elevated serum CRP levels, and sterile pyuria are significantly correlated with adenovirus-positive KD.
  • These findings suggest potential biomarkers for differentiating adenovirus-positive KD from isolated adenovirus infection.
  • Early identification of these markers can facilitate timely diagnosis and intervention for affected children.
Keywords:
AdenovirusInfectionKawasaki disease

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