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What Does This ESR Level For A Child Suffering From Kawasaki Disease Indicate?
my 3-yr old daughter was diagnosed with Kawasaki disease. She has undergone IVIG. Before her IVIG her ESR level was at 45. 1 week after IVIG, her ESR went up to 55. Is that critical? Her doctor advised to continue aspiring for next 3 months and do another 2D ECHO after a month.
Sun, 29 Nov 2020
Hi,
Kawasaki disease's diagnosis based mainly clinical criteria with some laboratory findings. The clinical features which include fever for at least 5 days and four or more of the major five clinical features such as conjunctival injection, cervical lymphadenopathy, oral mucosal changes, polymorphous rash, swelling or redness of extremities and on ECHO, coronary abnormalities may be observed. Laboratory findings may support the diagnosis of Kawasaki disease. Some laboratory abnormalities including anemia, hypoalbuminemia etc may become quite pronounced in Kawasaki disease.
Acute phase reactants including ESR, CRP level are particularly helpful because they usually are elevated to a degree not typically found in common viral infections. ESR is often above 40 mm per hour and is not uncommon, it is elevated to levels of at least 100 mm per hour, CRP typically reaches levels of 3 mg per dL or more. Of note, intravenous immunoglobulin (IVIG) elevates the ESR like your daughter's case; therefore, the CRP test is more accurate after IVIG therapy.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Zubayer Alam, General And Family Physician
Kawasaki disease's diagnosis based mainly clinical criteria with some laboratory findings. The clinical features which include fever for at least 5 days and four or more of the major five clinical features such as conjunctival injection, cervical lymphadenopathy, oral mucosal changes, polymorphous rash, swelling or redness of extremities and on ECHO, coronary abnormalities may be observed. Laboratory findings may support the diagnosis of Kawasaki disease. Some laboratory abnormalities including anemia, hypoalbuminemia etc may become quite pronounced in Kawasaki disease.
Acute phase reactants including ESR, CRP level are particularly helpful because they usually are elevated to a degree not typically found in common viral infections. ESR is often above 40 mm per hour and is not uncommon, it is elevated to levels of at least 100 mm per hour, CRP typically reaches levels of 3 mg per dL or more. Of note, intravenous immunoglobulin (IVIG) elevates the ESR like your daughter's case; therefore, the CRP test is more accurate after IVIG therapy.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Zubayer Alam, General And Family Physician
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