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

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

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