Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-09T07:51:42.128Z Has data issue: false hasContentIssue false
  • English
  • Français

Extremely refractory Kawasaki disease with disseminated intravascular coagulation

Published online by Cambridge University Press:  07 March 2017

Young Kwon Koh ,
Jae Hee Lee  and
Yeong Bong Park
Young Kwon Koh
Affiliation:
Department of Pediatrics, Chosun University School of Medicine, Gwangju, Republic of Korea
Jae Hee Lee
Affiliation:
Department of Pediatrics, Chosun University School of Medicine, Gwangju, Republic of Korea
Yeong Bong Park*
Affiliation:
Department of Pediatrics, Chosun University School of Medicine, Gwangju, Republic of Korea
*
Correspondence to: Y. B. Park, Department of Pediatrics, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 61452, Republic of Korea. Tel: +82 62 220 3041; Fax: +82 62 227 2904, E-mail: ybpark@chosun.ac.kr
Get access Rights & Permissions [Opens in a new window]

Abstract

Disseminated intravascular coagulation is a rare complication of Kawasaki disease and appears in <0.1% of Kawasaki disease patients. We report a case of refractory Kawasaki disease complicated with disseminated intravascular coagulation and giant coronary aneurysm. A 5-month-old boy presented with Kawasaki disease with coagulopathy. Although the coagulopathy improved after fresh-frozen plasma and antithrombin-III administration, the fever persisted despite two rounds of intravenous immunoglobulin, along with intravenous methylprednisolone pulse therapy and infliximab administration. Despite all efforts to treatment, the patient had giant coronary aneurysms and died suddenly.

Keywords

Kawasaki diseasedisseminated intravascular coagulationcoronary aneurysm
Type
Brief Report
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 1004 - 1007
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Levi, M, Ten Cate, H. Disseminated intravascular coagulation. N Engl J Med 1999; 341: 586–592.CrossRefGoogle ScholarPubMed
2. Sakurai, Y, Takatsuka, H, Onaka, M, Takada, M, Nishino, M. Persistent endothelial damage after intravenous immunoglobulin therapy in Kawasaki disease. Int Arch Allergy Immunol 2014; 165: 111–118.CrossRefGoogle ScholarPubMed
3. Nakamura, Y, Yashiro, M, Uehara, R, et al. Epidemiologic features of Kawasaki disease in Japan: results of the 2007–2008 nationwide survey. J Epidemiol 2010; 20: 302–307.CrossRefGoogle ScholarPubMed
4. Usui, D, Ishii, Y, Akaike, H, et al. Yersinia pseudotuberculosis type 4a infection meeting the diagnostic criteria for Kawasaki disease complicated by disseminated intravascular coagulation. Kansenshogaku Zasshi 2005; 79: 895–899.CrossRefGoogle ScholarPubMed
5. Comenzo, RL, Malachowski, ME, Meissner, HC, Fulton, DR, Berkman, EM. Immune hemolysis, disseminated intravascular coagulation, and serum sickness after large doses of immune globulin given intravenously for Kawasaki disease. J Pediatr 1992; 120: 926–928.CrossRefGoogle ScholarPubMed
6. Huang, L-W, Sun, W, Huang, F-Y. Kawasaki disease presenting with disseminated intravascular coagulation: report of one case. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1993; 35: 341–344.Google Scholar
7. Parvathy, V, Manuel, AD, Criton, S, Rajesh, G. Kawasaki disease with DIC as a complication. Indian J Pediatr 2007; 74: 1049.CrossRefGoogle ScholarPubMed
8. Lee, SH, Jeon, YH, Yang, HJ, Pyun, BY. Pleural effusion and disseminated intravascular coagulopathy: the rarely reported complications of kawasaki disease. Clin Pediatr 2010; 49: 598–600.Google ScholarPubMed
9. Niwa, K, Aotsuka, H, Hamada, H, Uchishiba, M, Terai, M, Niimi, H. Thrombocytopenia: a risk factor for acute myocardial infarction during the acute phase of Kawasaki disease. Coron Artery Dis 1995; 6: 857–864.Google ScholarPubMed
10. Nofech-Mozes, Y, Garty, B-Z. Thrombocytopenia in Kawasaki disease: a risk factor for the development of coronary artery aneurysms. Pediatr Hematol Oncol 2003; 20: 597–601.CrossRefGoogle ScholarPubMed