Laboratory Biomarkers to Facilitate Differential Diagnosis between Measles and Kawasaki Disease in a Pediatric Emergency Room: A Retrospective Study

Danilo Buonsenso; Giulia Macchiarulo; Maria Chiara Supino; Francesco La Penna; Simona Scateni; Alessandra Marchesi; Antonino Reale; Elena Boccuzzi

doi:10.4084/MJHID.2018.033

Laboratory Biomarkers to Facilitate Differential Diagnosis between Measles and Kawasaki Disease in a Pediatric Emergency Room: A Retrospective Study

Mediterr J Hematol Infect Dis. 2018 May 1;10(1):e2018033. doi: 10.4084/MJHID.2018.033. eCollection 2018.

Authors

Danilo Buonsenso^{1

2}, Giulia Macchiarulo^{1

3}, Maria Chiara Supino⁴, Francesco La Penna¹, Simona Scateni¹, Alessandra Marchesi⁵, Antonino Reale¹, Elena Boccuzzi¹

Affiliations

¹ Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
² Institute of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica Sacro Cuore, Rome, Italy.
³ Department of Systems Medicine, "University of Rome Tor Vergata", Rome, Italy.
⁴ School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy.
⁵ General Pediatric and Infectious Disease Unit, Internal Care Department, Bambino Gesù Children's Hospital, Rome, Italy.

Abstract

This retrospective study was conducted to analyze clinical and laboratoristic parameters to individuate specific differences and facilitate differential diagnosis between Measles and Kawasaki Disease (KD) at first evaluation in an emergency room. We found similar clinical features as duration of fever and number of KD criteria (p > 0.5) but significant differences in white blood cell count, neutrophils, CRP and LDH levels (p < 0.001). LDH value ≥ 800 mg/dl had sensibility of 89% and specificity of 90% for Measles while CRP ≥ 3 mg/dl had sensibility 89% and specificity of 85% for KD. The combined use of CRP, LDH and AST showed accuracy of 86.67%.

Keywords: Kawasaki disease; Measles.