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A girl with extremely refractory Kawasaki disease: an instructive case with unusual course and outcome

Published online by Cambridge University Press:  21 September 2011

Kossiva Lydia*
Affiliation:
Second Department of Pediatrics, ‘P&A Kyriakou’ Children's Hospital, University of Athens, Athens, Greece
Karanassios Evangelos
Affiliation:
Department of Pediatric Cardiology, ‘Aghia Sophia’ Children's Hospital, Athens, Greece
Papadopoulos George
Affiliation:
Department of Pediatric Cardiology, ‘P&A Kyriakou’ Children's Hospital, Athens, Greece
Karavanaki Kyriaki
Affiliation:
Second Department of Pediatrics, ‘P&A Kyriakou’ Children's Hospital, University of Athens, Athens, Greece
*
Correspondence to: Dr K. Lydia, Second Department of Pediatrics, ‘P&A Kyriakou’ Children's Hospital, University of Athens, 12, Kotieou str 11521, Athens, Greece. Tel: +30 210 6429289; Fax: +30 210 6469212; E-mail: lydiakossiva@hotmail.com

Abstract

Kawasaki disease constitutes an acute febrile vasculitis of unknown aetiology. It is considered the most common cause of acquired cardiac failure in children. Although standard treatment comprises intravenous immunoglobulin and aspirin, some children exhibit refractory disease, necessitating the use of alternative therapies such as corticosteroids and anti-tumour necrosis factor-alpha. For these cases, few controlled data are available. This report focuses on an extremely refractory classical Kawasaki disease with coronary artery aneurysms and ongoing inflammation. We discuss the therapeutic approaches and the potential pitfalls undertaken, which led to an unfavourable clinical outcome.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 2012

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