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What laboratory investigations are recommended to support the diagnosis of Kawasaki Disease?
Answer
Guideline-Aligned (High Confidence)
Generated by iatroX. Developer: Dr Kola Tytler MBBS CertHE MBA MRCGP (General Practitioner).
Last reviewed: 16 August 2025
Laboratory investigations recommended to support the diagnosis of Kawasaki Disease include:
- Full blood count to identify leukocytosis with neutrophilia and normocytic normochromic anaemia, which are common inflammatory markers in Kawasaki Disease 1 (Dimitriades et al., 2014).
- Elevated inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are typically present and support the diagnosis 1 (Rashid et al., 2014).
- Elevated liver enzymes (transaminases) and hypoalbuminaemia may be observed, reflecting systemic inflammation and hepatic involvement (Dimitriades et al., 2014).
- Urinalysis may show sterile pyuria, which is a supportive but nonspecific finding 1 (Rashid et al., 2014).
- Platelet count is often normal or low in the acute phase but typically rises (thrombocytosis) in the subacute phase, which can aid in diagnosis and monitoring 1 (Dimitriades et al., 2014).
- Additional emerging biomarkers such as noncoding RNAs have been investigated for diagnostic significance, but these are not yet standard clinical tests (Zhong et al., 2022).
In summary, the diagnosis of Kawasaki Disease is supported by laboratory evidence of systemic inflammation (raised CRP, ESR), haematological changes (leukocytosis, thrombocytosis), and exclusion of other causes, in conjunction with clinical criteria 1 (Dimitriades et al., 2014; Rashid et al., 2014; Zhong et al., 2022).
Key References
- NG143 - Fever in under 5s: assessment and initial management
- CKS - Feverish children - risk assessment and management
- CKS - Parvovirus B19 infection
- CG95 - Recent-onset chest pain of suspected cardiac origin: assessment and diagnosis
- (Dimitriades et al., 2014): Kawasaki disease: pathophysiology, clinical manifestations, and management.
- (Rashid et al., 2014): Kawasaki disease and its treatment - an update.
- (Zhong et al., 2022): Diagnostic significance of noncoding RNAs in kawasaki disease: A systematic review and meta-analysis.
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