Kawasaki disease laboratory findings

Kawasaki disease is diagnosed by clinical presentation, although the laboratory findings are non-specific for the diagnosis of Kawasaki disease – normocytic anemia, thrombocytosis, with platelets ≥ 450×10³/μL (after first week of acute disease), leucocytosis with white blood cell count ≥ 15,000/μL, elevated erythrocyte sedimentation rate, elevated liver enzyme levels, hypoalbuminemia with ≥ 3.0g/dL, elevated c-reactive protein, hyponatremia and sterile pyuria can be noted on laboratory investigations.

Although non-specific for diagnosis, the following laboratory findings are helpful in the diagnosis of Kawasaki disease:^[1][2][3][4]

• Complete blood count (CBC) may reveal:
  • Normocytic normochromic anemia
  • Thrombocytosis
    • Platelets ≥ 450×10³/μL (450 × 10⁹/L) after the first week and peaking to a mean of ≈700,000 per mm³ and normalizing after 4-6 weeks of onset of acute episode of Kawasaki disease
  • Leucocytosis
    • White blood cell count ≥ 15,000/μL (15.0 × 10⁹/L)
• Lipid profile
  • May demonstrate hypertriglyceridemia
• Elevated erythrocyte sedimentation rate
• Elevated c-reactive protein
• Hypercoagulation profile
  • May or may not demonstrate evidence of hypercoagulability
  • Panel should include thrombomodulin, tissue factor, tissue factor pathway inhibitor, Von Willebrand factor, coagulation factor VII, activated factor VII, prothrombin fragment 1 + 2, and D-dimer.
• Liver function tests may reveal:
  • Elevated liver enzyme levels
  • Hypoalbuminemia ≥ 3.0g/dL (30g/L)
• Electrolyte study may reveal hyponatremia
• Urine analysis may demonstrate sterile pyuria

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