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Kawasaki disease: Are we missing the diagnosis
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     Department of Pediatrics, AIIMS, New Delhi, India

    Sir

    We appreciate the interest shown by Khubchandani & Khemani and Kumar & Mathews in our article on "Kawasaki disease: are we missing the diagnosis".[1]

    The aim of reporting our experience was to create awareness among pediatricians so that cases of Kawasaki disease (KD) are not missed. At the time of submitting the article, a literature search was done and an attempt was made to include all the articles case reports till date. The article identified from literature depends on the search strategy adopted. This is also reflected in the differences in the studies collated by Khubchandani & Khemani and Kumar & Mathews.

    Some more reports[2],[3],[4],[5] of KD and a review[6] were published by Indian authors after the article was submitted and were not cited in our article. Some single case reports[7],[8] and a report of incomplete KD[9] were not cited in our article.

    We are thankful to Khubchandani & Khemani and Kumar & Mathews for bringing it out to the notice of readers few more cases. This further strengthens our belief that there are more cases of KD in India and we are missing them. Even publication of updated list does not give the total cases occurring in India or the incidence of KD as the cases may not be reported or may be published in non indexed journals.

    It may be worthwhile to set up national registry in the country to improve the reporting of cases and therefore attempt to estimate the burden of the disease.

    References

    1. Sridhar MR, Goel H Anirudh D, Lodha R, Kabra SK. Kawasaki disease: are we missing the diagnosis. Indian J Pediatr 2005; 72: 873-875.

    2. Singh S, Bansal A, Gupta A, Kumar RM, Mittal BR. Kawasaki disease. Int Heart Disease 2005; 46 : 679-689.

    3. Narayan SN, Ahmad MZ, Safia M. Cardiovascular involvement in Kawasaki disease. Indian Pediatr 2005; 42: 918-922.

    4. Bhatt M, Anil SR, Sivakumar K, Kumar K. Neonatal Kawasaki disease. Indian J Pediatr 2004; 71 : 353-354.

    5. Antony D, Jessy PL. Involvement of BCG Scar in Kawasaki Disease. Indian Pediatr 2005; 42: 83-84.

    6. Singh S, Kansara S. Kawasaki disease. Natl Med J India 2005; 18: 20-24.

    7. Bagyaraj B, Krishnan U, Farzana F. Kawasaki disease in India. Indian J Pediatr 2003; 70: 919-922.

    8. Managoli S, Chaturvedi P. Kawasaki disease with coronary artery aneurysm and symptomatic pneumonia. Indian Pediatr 2003; 40 : 1106-1107.

    9. Parmar RC, Somale A, Bavdekar SB, Muranjan MN. Incomplete Kawasaki disease with recurrent skin peeling: a case report with the review of literature. J Postgrad Med 2003; 49 : 72-74.(Kabra SK, Lodha Rakesh)