Kawasaki disease without changes in inflammatory biomarkers: A case report

Area of Science:

• Pediatric Rheumatology
• Immunology
• Clinical Diagnostics

Background:

• Kawasaki disease (KD) diagnosis typically relies on clinical symptoms and elevated inflammatory markers like CRP, ESR, and SAA.
• Arterial inflammation is a hallmark of KD, often reflected in acute-phase reactant levels.

Observation:

• A 1-year-old boy presented with KD symptoms but lacked elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), or serum amyloid A protein (SAA).
• Leucine-rich alpha-2-glycoprotein 1 levels also remained normal throughout hospitalization.

Findings:

• The patient was diagnosed with KD based on clinical presentation despite atypical laboratory results.
• Treatment with intravenous immunoglobulin (IVIG) and aspirin was initiated, with fever resolving after multiple IVIG doses.

Implications:

• This case emphasizes the importance of clinical judgment in diagnosing KD, even with normal inflammatory markers.
• Further research is needed to identify novel biomarkers for KD variants that may not necessitate standard treatment.