In the Emergency Department
Kawasaki disease is a clinical diagnosis but as many children have “incomplete” Kawasaki disease, some investigations, although nonspecific, are useful in supporting a diagnosis.
| Investigation | Result | Comment |
| FBC |
WCC >15 Hb Mild to moderate anaemia Platelets >450 (peaks at 3rd week) |
Kawasaki disease is an inflammatory process with elevation of WCC, CRP and ESR. The absence of significant inflammation makes the diagnosis of Kawasaki disease unlikely. |
| CRP | Raised | |
| ESR | >40 | |
| LFTs |
Albumin <30 ALT Elevated Bilirubin Raised in 10% |
Hepatitis can develop with 40% of patients having raised aminotransferases |
| Urinalysis | Sterile pyuria | Abnormal urinalysis should prompt culture of sample to exclude UTI |
| Chest X-ray | Cardiomegaly or evidence of heart failure | |
| ECG | Conduction abnormalities, myocardial ischaemia |