Kawasaki disease shock syndrome: A report of two cases and literature review

IMPORTANCE: Kawasaki disease shock syndrome (KDSS) is a rare Kawasaki disease (KD) manifestation. The pediatricians are not aware of the full range of clinical characteristics of KDSS. OBJECTIVE: We aimed to investigate the clinical features, diagnosis and treatment of KDSS in two patients and we included a literature review. METHODS: We collected and analyzed the clinical data for two patients with KDSS. Additionally, using “Kawasaki diseases shock syndrome” as a key phrase, we searched PubMed, Biotechnology Information and Wanfang Data Knowledge Service Platform databases for any similar reports between January 2009 and March 2017. RESULTS: Both of our patients diagnosed with KD developed sustained hypotension during the course of intravenous immunoglobulin treatment, as well as hypoalbuminemia, and increased C‐reactive protein and brain natriuretic peptide levels during hypotension. Both patients responded well to fluid resuscitation and inotropic support. No aneurysms formed in either patient during follow‐up. We reviewed two related studies in Chinese and 11 studies in English. INTERPRETATION: KD may present with severe shock, and requires proper diagnosis and rapid treatment. The prognosis for most patients with KDSS is excellent.