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To the Editor: The recent report on “Kawasaki Disease (KD) and Dengue” is very interesting [1]. Jagadeesh et al. noted that “prospective studies would be required to examine whether dengue could be a potential etiological agent of KD” and also mentioned that “our patient did not have thrombocytosis or thrombocytopenia, probably because of the simultaneous occurrence of KD and dengue [1].” In fact, many patients with KD have the serological positivity towards dengue [2]. The concurrent occurrence of the two disorders is usually problematic and difficult to diagnose [3, 4]. As noted by Burgner and Harnden, “KD is due to one or more widely distributed infectious agent(s), which evoke an abnormal immunological response in genetically susceptible individuals [5].” Hence, to clarify the exact relationship between dengue and KD needs advanced immunological study. Indeed, not only dengue but also other viruses, such as respiratory viruses [6], can concurrently occur with KD. In the present study, it is not clear whether there was complete exclusion of other diseases that might result in occurrence of KD. If it was a case of dengue induced KD, there should have been some periods of pathological immunological induction and the balancing between thrombocytosis or thrombocytopenia should not have occured.
References
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Joob, B., Wiwanitkit, V. Kawasaki Disease in a 2-year-old Child with Dengue Fever: Correspondence. Indian J Pediatr 83, 1054 (2016). https://doi.org/10.1007/s12098-015-2017-7
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DOI: https://doi.org/10.1007/s12098-015-2017-7