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Gastrointestinal involvement in Kawasaki disease: a case report

Published online by Cambridge University Press:  02 July 2018

Denizhan Bagrul Open the ORCID record for Denizhan Bagrul [Opens in a new window] ,
Elif G. Karadeniz  and
Serhat Koca
Denizhan Bagrul*
Affiliation:
Department of Pediatric Cardiology, Education and Research Hospital, Rize Recep Tayyip Erdoğan University, Rize, Turkey
Elif G. Karadeniz
Affiliation:
Department of Pediatrics, Education and Research Hospital, Rize Recep Tayyip Erdoğan University, Rize, Turkey
Serhat Koca
Affiliation:
Department of Pediatric Cardiology, Ankara Yuksek İhtisas Education and Research Hospital, Ankara, Turkey
*
Author for correspondence: D. Bagrul, MD, Department of Pediatric Cardiology, Faculty of Medicine, Recep Tayyip Erdogan University, Islampasa Mah., 53100 Rize, Turkey. Tel: +90 5079409399; Fax: +90 4642130644; E-mail: Denizhanbagrul@hotmail.com
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Abstract

Kawasaki disease is an acute febrile multisystem vasculitis. The term Incomplete Kawasaki disease is used in the presence of a minimum of two diagnostic criteria of clinical Kawasaki syndrome accompanied by at least 5 days of fever, the absence of any other reasons characterising the disease, and the presence of severe systemic inflammation findings. Gastrointestinal symptoms, notably diarrhoea, abdominal pain, and vomiting, frequently occur, and elevated serum aminotransferases, gallbladder hydrops, and rarely other forms of gastrointestinal involvement such as ischaemic colitis, intussusception, hepatic necrosis, splenic infarct, intestinal pseudo-obstruction, colitis, and colon oedema are also reported. In this paper, we present an incomplete and atypical Kawasaki case that explicitly shows gastrointestinal involvement. Progressive bowel oedema was detected in the patient presenting with severe abdominal pain and distension. We determined an aneurysm in the right coronary artery and diffuse dilatation in the left main coronary artery despite administration of early intravenous immunoglobulin. In addition to the cardiac problem, hypoalbuminaemia, electrolyte imbalance, sterile pyuria, hepatosplenomegaly, and hydrops of the gallbladder were observed in the case. All findings, including progressive bowel oedema accompanying abdominal distension, improved markedly after the second dose of intravenous immunoglobulin.

Keywords

Kawasaki diseaseabdominal distensionbowel oedema

Information

Type
Brief Report
Information
Cardiology in the Young , Volume 28 , Issue 8 , August 2018 , pp. 1070 - 1073
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Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Bagrul D, Karadeniz EG, Koca S. (2018) Gastrointestinal involvement in Kawasaki disease: a case report. Cardiology in the Young 28: 1070–1073. doi: 10.1017/S1047951118000847

References

1. Newburger, JW, Takahashi, M, Gerber, MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease. Circulation 2004; 110: 2747–2771.Google Scholar
2. Principi, N, Rigante, D, Esposito, S. The role of infection in Kawasaki syndrome. J Infect 2013; 67: 1–10.Google Scholar
3. Abe, J, Kotzin, BL, Jujo, K, et al. Selective expansion of T cells expressing T-cell receptor variable regions Vβ2 and Vβ8 in Kawasaki disease. Proc Natl Acad Sci U S A 1992; 89: 4066–4070.Google Scholar
4. Baker, AL, Lu, M, Minich, LL, et al. Associated symptoms in the ten days before diagnosis of Kawasaki disease. J Pediatr 2009; 154: 592–595.Google Scholar
5. El-Adawy, M, Dominguez, SR, Anderson, MS, et al. Abnormal liver panel in acute Kawasaki disease. Pediatr Infect Dis J 2011; 30: 141.Google Scholar
6. Bader-Meunier, B, Hadchouel, M, Fabre, M, et al. Intrahepatic bile duct damage in children with Kawasaki disease. J Pediatr 1992; 120: 750–752.CrossRefGoogle ScholarPubMed
7. Suddleson, EA, Reid, B, Woolley, MM, et al. Hydrops of the gallbladder associated with Kawasaki syndrome. J Pediatr Surg 1987; 22: 956–959.Google Scholar
8. Zulian, F, Falcini, F, Zancan, L, et al. Acute surgical abdomen as presenting manifestation of Kawasaki disease. J Pediatr 2003; 142: 731–735.CrossRefGoogle ScholarPubMed
9. Chen, CJ, Huang, FC, Tiao, MM, et al. Sonographic gallbladder abnormality is associated with intravenous immunoglobulin resistance in Kawasaki disease. Scientific World Journal 2012; 2012: 485758.Google Scholar
10. Miyake, T, Kawamori, J, Yoshida, T, et al. Small bowel pseudo-obstruction in Kawasaki disease. Pediatr Radiol 1987; 17: 383–386.Google Scholar
11. Maurer, K, Unsinn, KM, Waltner-Romen, M, et al. Segmental bowel-wall thickening on abdominal ultrasonography: an additional diagnostic sign in Kawasaki disease. Pediatr Radiol 2008; 38: 1013–1016.Google Scholar
12. Amano, S, Hazama, F, Kubagawa, H, et al. General pathology of Kawasaki disease. Acta Pathol 1980; 30: 681–694.Google ScholarPubMed
13. Nagata, S, Yamashiro, Y, Maeda, M, et al. Immunohistochemical studies on small intestinal mucosa in Kawasaki disease. Pediatr Res 1993; 33: 557–563.Google Scholar