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Capillary leak leading to shock in Kawasaki disease without myocardial dysfunction

Published online by Cambridge University Press:  21 September 2011

Julia Natterer
Affiliation:
Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital and University of Lausanne, CHUV, Switzerland
Marie-Hélène Perez*
Affiliation:
Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital and University of Lausanne, CHUV, Switzerland
Stefano Di Bernardo
Affiliation:
Pediatric Cardiology Unit, Department of Pediatrics, University Hospital and University of Lausanne, CHUV, Switzerland
*
Correspondence to: M.-H. Perez, Pediatric Intensive Care, Department of Pediatrics, University Hospital and University of Lausanne, CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland. Tel: 0041 79 556 40 82; Fax: 0041 21 314 37 59; E-mail: marie-helene.perez@chuv.ch

Abstract

Kawasaki disease is an acute vasculitis of childhood. Its clinical presentation is well known, and coronary artery aneurysms are classical complications. Shock and pleural or pericardiac effusion are rare presentations of the disease. In intensive care units, the disease may be mistaken for septic shock or toxic shock syndrome. Owing to the fact that immunoglobulin therapy improves the course of the disease, especially if given early, and thus the diagnosis should not be delayed.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 2012

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References

1.Newburger, JW, Takahashi, M, Gerber, MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004; 110: 27472771.CrossRefGoogle Scholar
2.Cha, S, Yoon, M, Ahn, Y, Han, M, Yoon, KL. Risk factors for failure of initial intravenous immunoglobulin treatment in Kawasaki disease. J Korean Med Sci 2008; 23: 718722.CrossRefGoogle ScholarPubMed
3.Gamillscheg, A, Zobel, G, Karpf, EF, et al. Atypical presentation of Kawasaki disease in an infant. Pediatr Cardiol 1993; 14: 223226.CrossRefGoogle ScholarPubMed
4.Hamada, H, Terai, M, Honda, T, Kohno, Y. Marked pleural and pericardial effusion with elevated Vascular Endothelial Growth Factor production: an uncommon complication of Kawasaki disease. Pediatr Int 2005; 47: 112114.CrossRefGoogle ScholarPubMed
5.Sittiwangkul, R, Pongprot, Y. Large pleural effusion: an unusual manifestation of Kawasaki disease. Clin Pediatr (Phila) 2004; 43: 389391.CrossRefGoogle ScholarPubMed
6.Amano, S, Hazama, F, Kubagawa, H, Tasaka, K, Haebara, H, Hamashima, Y. General pathology of Kawasaki disease. On the morphological alterations corresponding to the clinical manifestations. Acta Pathol Jpn 1980; 30: 681694.Google ScholarPubMed
7.Terai, M, Honda, T, Yasukawa, K, Higashi, K, Hamada, H, Kohno, Y. Prognostic impact of vascular leakage in acute Kawasaki disease. Circulation 2003; 108: 325330.CrossRefGoogle ScholarPubMed
8.Yasukawa, K, Terai, M, Shulman, ST, et al. Systemic production of vascular endothelial growth factor and fms-like tyrosine kinase-1 receptor in acute Kawasaki disease. Circulation 2002; 105: 766769.CrossRefGoogle ScholarPubMed
9.Wiesenthal, AM, Todd, JK. Toxic shock syndrome in children aged 10 years or less. Pediatrics 1984; 74: 112117.CrossRefGoogle ScholarPubMed
10.Dominguez, SR, Friedman, K, Seewald, R, Anderson, MS, Willis, L, Glode, MP. Kawasaki disease in a pediatric intensive care unit: a case–control study. Pediatrics 2008; 122: e786e790.CrossRefGoogle Scholar