1/34. Concomitant dengue hemorrhagic fever with Kawasaki disease.This is an unique case report of concomitant dengue hemorrhagic fever and Kawasaki disease, not reported previously. The unusual clinical course of persistent fever, coronary artery involvement evidenced from 2-D echocardiogram, and hydrops of the gallbladder is discussed.- - - - - - - - - - ranking = 1keywords = hydrops (Clic here for more details about this article) |
2/34. Acute febrile cholestasis as an inaugural manifestation of Kawasaki's disease.We report a child who developed acute febrile cholestasis with jaundice and pruritus as the inaugural manifestation of Kawasaki's disease (KD). The severe obstructive icterus and hydrops of the gallbladder required cholecystectomy that was not followed by remission of the fever and cholestasis. KD was suspected after the exclusion of all infectious, metabolic and neoplastic conditions responsible for acute cholestasis. The administration of intravenous gammaglobulin (IVGG) promptly induced defervescence and improvement of the patient's general condition. Mucocutaneous alterations, peeling of the digits, right cervical lymph node enlargement and bilateral non-suppurative conjunctivitis supporting the diagnosis of KD developed 14 days after the appearance of jaundice. No coronary abnormalities had developed after 2 years of follow-up. We conclude that this syndrome should be suspected in any child with febrile cholestasis of unknown origin, in order that coronary involvement may be prevented by the administration of IVGG.- - - - - - - - - - ranking = 1keywords = hydrops (Clic here for more details about this article) |
3/34. Kawasaki syndrome.Kawasaki syndrome, also known as mucocutaneous lymph node syndrome, is an acute vasculitis of infants and young children. We describe a four-year-old girl who presented with fever, a diffuse erythematous maculopapular rash, bilateral nonpurulent bulbar conjunctivitis, dry, red, fissured lips, a tongue with a strawberry "appearance", an erythematous pharynx, indurative erythema, and edema and desquamation of the face, hands and feet. She probably developed mitral valve prolapse during the course of the disease. The diagnosis of Kawasaki syndrome was arrived at by excluding other diseases and by the presence of all the clinical criteria for Kawasaki syndrome. Since this syndrome is rarely encountered in turkey, this case is presented and the literature regarding the syndrome is reviewed.- - - - - - - - - - ranking = 0.0020924096172785keywords = edema (Clic here for more details about this article) |
4/34. An unusual pattern of arthritis in a child with Kawasaki syndrome.arthritis is reported in one-third of cases with Kawasaki syndrome. It may have an early or a late onset form. We present a 15-month-old-girl who had been referred with complaints of pain and swelling in her left shoulder. physical examination revealed bulbar conjunctival injection, erythematous lips and pharynx, strawberry tongue, erythematous rash, edema and erythema of the left shoulder, left knee, right elbow and right wrist, and moderate distress in the left shoulder and left hip. She was diagnosed with Kawasaki syndrome, and intravenous immunoglobulin infusion (IVIG) 2 g/kg and aspirin (100 mg/kg/day) were instituted. The patient had two additional episodes of arthritis involving the hip joint on the 8th day, and the shoulder and metacarpophalangeal (MCP) and interphalangeal (IP) joints of her right hand on the 15th day. Turbid material was aspirated in both instances; Gram and Wright's staining of this material showed many leukocytes but no bacteria. A second dose of IVIG (1 g/kg) was given. At the end of the third week all extremities were painless, with a normal range of motion. arthritis in our patient was the presenting sign, having a 'septic arthritis mimicking' and 'biphasic' pattern. Although the patient presented with severe and recurrent arthritis, which is significantly correlated with severe multisystem disease and the presence or development of coronary artery aneurysm, the response to IVIG was excellent.- - - - - - - - - - ranking = 0.0020924096172785keywords = edema (Clic here for more details about this article) |
5/34. Painful jaundice revealing Kawasaki disease in a young man.liver involvement is usually a minor manifestation of Kawasaki disease and includes hepatobiliary dysfunction or gallbladder hydrops. We describe here an unusual case of jaundice revealing an adult onset Kawasaki disease. An 18-year-old man presented with abdominal pain and jaundice associated with cholestasis as the initial manifestation of Kawasaki disease. Abdominal evaluation (ultrasonography and CT-scan) did not find abnormality. Other signs typical of the Kawasaki disease occurred a few days later and permitted diagnosis. With aspirin and intravenous immunoglobulins, outcome was favorable without any cardiovascular complication. Our case suggests that Kawasaki disease should be added to the etiological list of painful febrile icterus in young patients.- - - - - - - - - - ranking = 1keywords = hydrops (Clic here for more details about this article) |
6/34. Kawasaki disease in the adult: a case report and review of the literature.Kawasaki disease, predominantly a disease of childhood, includes such symptoms as acute vasculitis, mucosal inflammation, rash, cervical adenopathy, and edema. Its most severe forms are associated with coronary artery aneurysms. We report a rare case of this disease in an asymptomatic adult and review its epidemiology, etiology, diagnosis, treatment, and prognosis.- - - - - - - - - - ranking = 0.0020924096172785keywords = edema (Clic here for more details about this article) |
7/34. Kawasaki disease with reye syndrome: report of one case.A seven-month-old girl was admitted to the pediatrics Department of Mackay Memorial Hospital with the following symptoms and signs: (1) high fever for more than five days; (2) injection of bilateral conjunctiva; (3) bright red lips with strawberry tongue; (4) edematous change of palms and soles, followed by digit desquamation; (5) an ill-defined, erythematous plaque on the scar of the BCG. Kawasaki disease was diagnosed, and high dose aspirin (100 mg/kg/day) and intravenous gamma-globulin (IVIG) (400 mg/kg/day) were given for four days. The patient was afebrile on the second day after IVIG infusion, and was discharged six days after admission. A small single daily dose of aspirin (10 mg/kg/day) was given after the afebrile days. Unfortunately, vomiting and consciousness disturbance were noted one day after discharge. Laboratory data showed elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ammonia. hypoglycemia and prolonged PT and PTT were also noted. reye syndrome was suspected, and the patient was admitted to the intensive care unit for further management. A liver biopsy gave findings consistent with reye syndrome. In spite of intensive treatment, the infant expired on the second day after admission. In a review of the literature, no correlation between these two syndromes was found. This rare case is presented to warn that reye syndrome may follow Kawasaki disease when aspirin has been prescribed at a high dose.- - - - - - - - - - ranking = 0.0020924096172785keywords = edema (Clic here for more details about this article) |
8/34. Catastrophic Kawasaki disease or juvenile polyarteritis nodosa?OBJECTIVE: Juvenile polyarteritis nodosa (PAN) and Kawasaki disease (KD) are disseminated vasculitides of unknown cause affecting small- and medium-sized vessels in children. We present an unusually severe case that fulfilled criteria for both KD and PAN. The diagnosis, overlapping clinical features, and treatment options for the 2 diseases are discussed. methods: A 3-year-old girl with systemic vasculitis is presented. We compare our case to 4 other cases reported in the literature which presented with a similar diagnostic dilemma. A review of the medical literature and a qualitative analysis of the diseases were performed, with emphasis on overlapping features, atypical cases, and treatment options. RESULTS: Many features of KD and PAN are shared; however, there are some clinical features that could help differentiate one from the other. fever, weight loss, rash, abdominal pain, arthritis, coronary arteritis, peripheral gangrene, anemia, leukocytosis, thrombocytosis, and elevated c-reactive protein are among many of the features that are shared by both diseases. However, KD also has unique clinical features that include conjunctivitis, changes in the lips and mouth, desquamation of the fingertips, and gallbladder hydrops, whereas renal involvement in KD is rare. CONCLUSIONS: Occasionally juvenile PAN and KD share clinical manifestations, and when they do, it may be impossible to differentiate between them. Treatment should be directed according to the severity and persistence of these clinical manifestations.- - - - - - - - - - ranking = 1keywords = hydrops (Clic here for more details about this article) |
9/34. Kawasaki's disease with paralytic ileus. A case report.The authors report on an 18 month-old boy affected by Kawasaki's disease (KD). The diagnosis of KD was made after exclusion of conditions with similar presentation. Two days after admission the child presented vomiting, abdominal distension, meteorism and increase of scrotal swelling with edema. An abdominal X-ray showed the presence of multiple water and gas levels in the ileum and subsequent diagnosis of paralitic ileus was made. After several evacuative enema the intestinal symptomatology resolved. The patient was treated twice (2 g/kg day and after 3 days again 2 g/kg day) with intravenous immunoglobulin following which he made an uneventful recovery. The authors conclude that the presence of paralytic ileus in a febrile child may represent an unusual clinical sign of KD and justify a timely commencement of intravenous immuno-globulin therapy.- - - - - - - - - - ranking = 0.0020924096172785keywords = edema (Clic here for more details about this article) |
10/34. Prolonged postprandial abdominal pain following Kawasaki syndrome with acute gallbladder hydrops: association with impaired gallbladder emptying.Acute hydrops of the gallbladder is a well-recognized complication of Kawasaki syndrome. We report a case of a child with this syndrome whose gallbladder hydrops slowly resolved after intravenous gamma-globulin therapy. However, he continued to experience postprandial right upper quadrant abdominal pain. Hepatobiliary scintigraphy revealed normal filling of the gallbladder but marked impairment of meal-stimulated gallbladder emptying. endoscopy with biopsy of the esophagus, stomach, and duodenum was normal, ruling out peptic complications of his aspirin therapy. This child's discomfort improved slowly over several months, finally ending approximately 6 months after the onset of his illness. A repeat gallbladder emptying study done ultrasonographically at that time revealed near-normal meal-stimulated gallbladder emptying. We conclude that poor emptying of the gallbladder may be associated with prolonged abdominal pain in Kawasaki syndrome. Meal-stimulated gallbladder emptying can be assessed by a simple ultrasonographic technique and should be considered in any patient with Kawasaki syndrome and abdominal pain.- - - - - - - - - - ranking = 6keywords = hydrops (Clic here for more details about this article) |
| | Next -> |