Sensorineural hearing loss in Kawasaki disease.

Sir,

I read with interest the case report by Aggarwal et al. on the sensorineural hearing loss (SNHL) in a child with Kawasaki disease (KD).[1] The authors state that “Because of the reported high incidence of the SNHL, we strongly recommend screening all children with KD for hearing loss.”[1] I presume that such recommendation ought to be cautiously taken. This is based on the following two points:

Recently published data pointed out that SNHL in children with KD might occur during treatment of the acute phase; SNHL usually involves mild bilateral hearing loss and recovers naturally.[2]

A significant association has been found between persistent SNHL, although often not initially noted, with certain variables in KD patients, namely, prolonged presence of thrombocytosis, anemia, high erythrocyte sedimentation rate, and the delayed use of intravenous administration of immunoglobulin after the first 10 days of illness.[3]

I, therefore, presume that instead of the audiological screening of all KD patients, as recommended by the authors, screening should be reserved for those patients with the aforementioned variables. This appears to be more justifiable and likely to disclose significant SNHL as well as it is cost-effective, particularly in an area with limited resources.

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Conflicts of interest

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