Extracriteria manifestations in Kawasaki disease: coronary threat or diagnostic pitfall?
Female sex independently linked to higher odds of extracriteria manifestations in Kawasaki disease
Extracriteria manifestations in Kawasaki disease: coronary threat or diagnostic pitfall?
UNLABELLED: Kawasaki disease (kawasaki disease) may present with manifestations beyond classical diagnostic criteria, but data on extracriteria manifestations as a multisystem phenotype remain limited.
We aimed to assess the frequency and clinical significance of extracriteria manifestations in children with kawasaki disease.
In this retrospective single-center study, we reviewed 254 children with kawasaki disease between January 2005 and December 2025.
female patients had 81% higher odds of extracriteria manifestations
Patients were compared according to extracriteria manifestations with respect to demographic, clinical, laboratory, echocardiographic, treatment, and coronary outcome variables.
Extracriteria manifestations were identified in 77 patients (30.3%).
Gastrointestinal involvement was most common (13.4%), followed by cardiovascular (non-coronary) and neurological involvement.
Extracriteria manifestations are common in kawasaki disease and are associated with greater inflammatory burden and longer hospitalization.
Extracriteria manifestations are common in kawasaki disease and are associated with greater inflammatory burden and longer hospitalization.
Female sex and higher C-reactive protein levels were independently associated with extracriteria manifestations, whereas coronary involvement, IVIG resistance, and follow-up coronary outcomes were similar between groups.
Early recognition of these presentations may facilitate timely diagnosis and management.