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Shock: an unusual presentation of Kawasaki disease

Abstract

Kawasaki disease (KD) is a common acute systemic vasculitis of childhood. Although KD has wide spectrum of clinical features, shock is not one of its common presentation form. We describe a 5-month-old female infant with severe shock syndrome requiring fluid resuscitation, inotropic support, and PICU admission. She was diagnosed retrospectively to have KD complicated by coronary artery aneurysms in spite of receiving early course of IV immunoglobulin. Conclusion: Diagnosis of KD could be missed in the pediatric intensive care unit because of its atypical presentation and the wide array of associated clinical symptoms. Subsequently, intensivists and emergency room physicians should maintain a high index of suspicion not to miss it or diagnose it at an advanced stage of the illness.

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References

  1. 1.

    Cimaz R, Sundel R (2009) Atypical and incomplete Kawasaki disease. Best Pract Res Clin Rheumatol 23:689–697

  2. 2.

    Dominguez SR, Friedman K, Seewald R et al (2008) Kawasaki disease in a pediatric intensive care unit: a case-control study. Pediatrics 122:e786–e790

  3. 3.

    Kanegaye JT, Wilder MS, Molkara D et al (2009) Recognition of Kawasaki disease shock syndrome. Pediatrics 123:e783–e789

  4. 4.

    Minich LL, Sleeper LA, Atz AM et al (2007) Delayed diagnosis of Kawasaki disease: what are the risk factors? Pediatrics 120:e1434–e1440

  5. 5.

    Newburger JA, Takahashi M, Gerber MA et al (2004) Diagnosis, treatment, and long-term management of Kawasaki disease. A statement for health professionals from the committee of rheumatic fever, endocarditis and Kawasaki disease, council on cardiovascular disease in the young, American heart association. Circulation 110:2747–2771

  6. 6.

    Palmer AL, Walker T, Smith JC (2005) Acute respiratory distress syndrome in a child with Kawasaki disease. Soth Med J 98:1031–1033

  7. 7.

    Thabet F, Bellara I, Tabarki B et al (2004) Ischemic colitis and hemophagocytosis complicating Kawasaki disease. Arch Pediatr 11:226–228

  8. 8.

    Yeo Y, Kim T, Ha K et al (2009) Incomplete Kawasaki disease in patients younger than 1 year of age: a possible inherent risk factor. Eur J Pediatr 168:157–162

  9. 9.

    Yim D, Ramsay J, Kothari D, Burgner D (2010) Coronary artery dilatation in toxic shock-Like syndrome: the Kawasaki disease shock syndrome. Pediatr Cardiol 31:1232–1235

  10. 10.

    Yoshikawa H, Nomura Y, Masuda K et al (2006) Four cases of Kawasaki syndrome complicated with myocarditis. Circ J 70:202–205

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Statement

This study is exempt from approval by our local ethics committee.

Author information

Correspondence to Farah Thabet.

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Thabet, F., Bafaqih, H., Al-Mohaimeed, S. et al. Shock: an unusual presentation of Kawasaki disease. Eur J Pediatr 170, 941–943 (2011). https://doi.org/10.1007/s00431-011-1426-5

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Keywords

  • Kawasaki disease
  • Shock
  • Inotropes
  • Echocardiography
  • Coronary arteries aneurysm
  • Immunoglobulin