Repositorio UFRO · Omeka S

Lymph-Node-First Presentation of Kawasaki Disease Compared with Bacterial Cervical Adenitis and Typical Kawasaki Disease

Primer Autor	Kanegaye, John T.
Co-autores	Van Cott, Elizabeth Tremoulet, Adriana H. Salgado, Andrea Shimizu, Chisato Kruk, Peter Hauschildt, John Sun, Xiaoying Jain, Sonia Burns, Jane C.
Título	Lymph-Node-First Presentation of Kawasaki Disease Compared with Bacterial Cervical Adenitis and Typical Kawasaki Disease
Editorial	MOSBY-ELSEVIER
Revista	JOURNAL OF PEDIATRICS
Lenguaje	en
Resumen	Objective To identify characteristics differentiating the node-first presentation of Kawasaki disease (NFKD) from bacterial cervical lymphadenitis (BCL) and typical Kawasaki disease (KD). Study design From our prospectively collected database, we compared clinical, laboratory, and imaging characteristics of NFKD and BCL cohorts and performed multivariable logistic regression to identify variables that distinguish NFKD from BCL. We then compared outcomes of patients with NFKD and patients with typical KD treated during the same period. Results Over 7 years, 57 patients were hospitalized for NFKD, 78 for BCL, and 287 for typical KD. Patients with NFKD were older and had more medical encounters and longer duration of illness before the correct diagnosis was made than did patients with BCL. Of patients with NFKD, 33% had an admission diagnosis of bacterial adenitis or abscess. Compared with patients with BCL, patients with NFKD had lower leukocyte (white blood cell), hemoglobin, and platelet counts and higher absolute band counts (ABCs), C-reactive protein (CRP), alanine transaminase and g-glutamyl transpeptidase levels, and erythrocyte sedimentation rates. In the multivariable analysis, smaller nodes, lower white blood cell count, and higher ABC and CRP were independently associated with NFKD. Patients with NFKD had multiple enlarged solid nodes and comparable rates of retropharyngeal edema. Compared with patients with typical KD, patients with NFKD were older, had more severe inflammation, and had similar rates of coronary artery abnormalities and resistance to intravenous immune globulin. Conclusions High ABC and CRP values and multiple enlarged solid nodes in febrile patients with cervical adenopathy should prompt consideration of NFKD to prevent delayed diagnosis of KD. Retropharyngeal edema on radiography should not dissuade from the diagnosis of NFKD.
Tipo de Recurso	Artículo original
Description	Supported in part by the National Heart, Lung, and Blood Institute at the National Institutes of Health (R01 HL69413 [to J.B. and J.K.] and K24- HL074864 [to J.B.]), the Hartwell Foundation (to A.T.), and the Harold Amos Medical Faculty Development Program from the Robert Wood Johnson Foundation (to A.T.). The authors declare no conflicts of interest. Este trabajo fue financiado en parte por el Instituto Nacional del Corazón, los Pulmones y la Sangre de los Institutos Nacionales de la Salud (R01 HL69413 [para J.B. y J.K.] y K24-HL074864 [para J.B.]), la Fundación Hartwell (para A.T.) y el Programa de Desarrollo de la Facultad de Medicina Harold Amos de la Fundación Robert Wood Johnson (para A.T.). Los autores declaran no tener conflictos de intereses.
doi	10.1016/j.jpeds.2012.11.064
Formato Recurso	pdf
Palabras Claves	LYMPHADENOPATHY LYMPHADENITIS ASSOCIATION DIAGNOSIS CHILDREN FEVER LINFADENOPATÍA LINFADENITIS ASOCIACIÓN DIAGNÓSTICO NIÑOS FIEBRE
Ubicación del archivo	http://dx.doi.org/10.1016/j.jpeds.2012.11.064
Materias	LYMPHADENOPATHY LYMPHADENITIS ASSOCIATION DIAGNOSIS CHILDREN FEVER LINFADENOPATÍA LINFADENITIS ASOCIACIÓN DIAGNÓSTICO NIÑOS FIEBRE
Disciplinas de la OCDE	Enfermedades Infecciosas Pediatría
Título de la cita (Recomendado-único)	Lymph-Node-First Presentation of Kawasaki Disease Compared with Bacterial Cervical Adenitis and Typical Kawasaki Disease
Revista/Libro	JOURNAL OF PEDIATRICS
Tipo de ruta	hibrida verde
Access Rights	restringido
Derechos de acceso	restringido
Identificador alternativo	PMID 23305955
Idioma	en
Identificador del recurso (Mandatado-único)	Artículo original
Versión del recurso (Recomendado-único)	versión publicada
Entidad financiadora	National Heart, Lung, and Blood Institute at the National Institutes of Health R01 HL69413#National Heart, Lung, and Blood Institute at the National Institutes of Health K24- HL074864#Hartwell Foundation#Robert Wood Johnson Foundation
Referencia del Financiador (Mandatado si es aplicable-repetible)	National Heart, Lung, and Blood Institute at the National Institutes of Health R01 HL69413 National Heart, Lung, and Blood Institute at the National Institutes of Health K24- HL074864 Hartwell Foundation Robert Wood Johnson Foundation
Editorial	MOSBY-ELSEVIER
ISSN	0022-3476
Página de inicio (Recomendado-único)	1259
Página final (Recomendado-único)	#ERROR!
Categoría WOS	Pediatría Pediatrics
Formato	pdf
Id de Web of Science	WOS:000319502700035