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Neonatal Kawasaki disease with multiple arterial aneurysms: a case report

BACKGROUND: Kawasaki disease (KD) is a medium vessel vasculitis that typically occurs in children aged between 6 months and 5 years. It is extraordinarily rare in the neonatal period. KD-related systemic artery aneurysms (SAAs) have never been reported in neonates. CASE PRESENTATION: A male infant w...

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Autores principales: Zhao, Qu-ming, Liang, Xue-cun, Wu, Lin, Liu, Fang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296651/
https://www.ncbi.nlm.nih.gov/pubmed/32539746
http://dx.doi.org/10.1186/s12969-020-00440-x
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author Zhao, Qu-ming
Liang, Xue-cun
Wu, Lin
Liu, Fang
author_facet Zhao, Qu-ming
Liang, Xue-cun
Wu, Lin
Liu, Fang
author_sort Zhao, Qu-ming
collection PubMed
description BACKGROUND: Kawasaki disease (KD) is a medium vessel vasculitis that typically occurs in children aged between 6 months and 5 years. It is extraordinarily rare in the neonatal period. KD-related systemic artery aneurysms (SAAs) have never been reported in neonates. CASE PRESENTATION: A male infant was transferred to our institution for persistent high-grade fever lasting 16 days. Symptoms started at day 14 of life, and he was admitted to a children’s hospital on the second day of fever. Physical examination at the time found no signs suggestive of KD. The only laboratory parameters which were of significance were values suggestive of systemic inflammation. However, his fever persisted and inflammatory markers continued to rise despite 2 weeks of antibiotic therapy. KD as a noninfectious cause of fever was considered when he came to our institution, and echocardiographic findings of left and right medium coronary artery aneurysms (CAAs) confirmed our suspicions. Full-body magnetic resonance angiography also revealed bilateral axillary artery aneurysms. Administration of intravenous gamma globulin resulted in rapid improvement. His fever resolved on the next day and CAAs and SAAs regressed to normal at 6 months and 3 months after diagnosis, respectively. CONCLUSION: This unique case of incomplete KD highlights the importance of considering KD in neonates with unexplained prolonged fever and reinforces the need to remain vigilant for SAAs in KD.
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spelling pubmed-72966512020-06-16 Neonatal Kawasaki disease with multiple arterial aneurysms: a case report Zhao, Qu-ming Liang, Xue-cun Wu, Lin Liu, Fang Pediatr Rheumatol Online J Case Report BACKGROUND: Kawasaki disease (KD) is a medium vessel vasculitis that typically occurs in children aged between 6 months and 5 years. It is extraordinarily rare in the neonatal period. KD-related systemic artery aneurysms (SAAs) have never been reported in neonates. CASE PRESENTATION: A male infant was transferred to our institution for persistent high-grade fever lasting 16 days. Symptoms started at day 14 of life, and he was admitted to a children’s hospital on the second day of fever. Physical examination at the time found no signs suggestive of KD. The only laboratory parameters which were of significance were values suggestive of systemic inflammation. However, his fever persisted and inflammatory markers continued to rise despite 2 weeks of antibiotic therapy. KD as a noninfectious cause of fever was considered when he came to our institution, and echocardiographic findings of left and right medium coronary artery aneurysms (CAAs) confirmed our suspicions. Full-body magnetic resonance angiography also revealed bilateral axillary artery aneurysms. Administration of intravenous gamma globulin resulted in rapid improvement. His fever resolved on the next day and CAAs and SAAs regressed to normal at 6 months and 3 months after diagnosis, respectively. CONCLUSION: This unique case of incomplete KD highlights the importance of considering KD in neonates with unexplained prolonged fever and reinforces the need to remain vigilant for SAAs in KD. BioMed Central 2020-06-15 /pmc/articles/PMC7296651/ /pubmed/32539746 http://dx.doi.org/10.1186/s12969-020-00440-x Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Zhao, Qu-ming
Liang, Xue-cun
Wu, Lin
Liu, Fang
Neonatal Kawasaki disease with multiple arterial aneurysms: a case report
title Neonatal Kawasaki disease with multiple arterial aneurysms: a case report
title_full Neonatal Kawasaki disease with multiple arterial aneurysms: a case report
title_fullStr Neonatal Kawasaki disease with multiple arterial aneurysms: a case report
title_full_unstemmed Neonatal Kawasaki disease with multiple arterial aneurysms: a case report
title_short Neonatal Kawasaki disease with multiple arterial aneurysms: a case report
title_sort neonatal kawasaki disease with multiple arterial aneurysms: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296651/
https://www.ncbi.nlm.nih.gov/pubmed/32539746
http://dx.doi.org/10.1186/s12969-020-00440-x
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