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<< Evidence-Based Management Of Kawasaki Disease In The Emergency Department

Diagnostic Testing

Since Kawasaki disease is characterized by acute inflammation, it is necessary to assess patients for elevated inflammatory markers. This includes the acute phase reactants, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). These are nearly universally elevated, with ESR being elevated in approximately 60% of Kawasaki disease patients, and CRP being elevated in as many as 80% of affected patients. Guidelines (such as those from the AAP) recommend testing both the CRP and ESR levels for best results.5 The AAP guidelines suggest that elevations of CRP ≥ 3.0 mg/dL and ESR ≥ 40 mm/h can be used in the evaluation of both complete and incomplete Kawasaki disease.5 Treatment with IVIG can lead to elevations in the ESR, so this test should not be used as the primary determiner of inflammation in treated patients.

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