Pediatric emergency medicine trisk 3010 3010

FIGURE 101.15 Evaluation of suspected Kawasaki disease. KD, Kawasaki disease; CRP, C-reactive
protein; ESR, erythrocyte sedimentation rate; ALT, alanine aminotransferase; WBC, white blood cell;
hpf, high-powered field; echo, echocardiogram. (Adapted with permission from Sundel RP. Kawasaki
disease: Clinical features and diagnosis. In: Post TW (Ed), UpToDate . Waltham, MA. Accessed March
4, 2019. Copyright ©2019 UpToDate, Inc. For more information visit www.uptodate.com .)

No laboratory studies are included in the diagnostic criteria for KD, but certain
findings may support the diagnosis. Most characteristic is systemic inflammation, with
widespread elevation of acute-phase reactants (including CRP and ESR), leukocytosis,
and a left shift in the white blood cell count. By the second week of illness, platelet
counts also rise, reaching 1,000,000/mm3 in the most severe cases. Thrombocytopenia
is a poor prognostic factor and may indicate platelet consumption.