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Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review

Hypertransaminasemia in patients with Kawasaki disease (KD) is reported to be transient. Here, we describe a child with an atypically protracted course of liver tests abnormalities and review the inherent literature. The patient was hospitalized at age 7-months for isolated hypertransaminasemia dete...

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Autores principales: Paglia, Pamela, Nazzaro, Lucia, De Anseris, Anna Giulia Elena, Lettieri, Milena, Colantuono, Rossella, Rocco, Maria Chiara, Siano, Maria Anna, Biffaro, Nicola, VAJRO, Pietro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293418/
https://www.ncbi.nlm.nih.gov/pubmed/34287369
http://dx.doi.org/10.3390/pediatric13030044
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author Paglia, Pamela
Nazzaro, Lucia
De Anseris, Anna Giulia Elena
Lettieri, Milena
Colantuono, Rossella
Rocco, Maria Chiara
Siano, Maria Anna
Biffaro, Nicola
VAJRO, Pietro
author_facet Paglia, Pamela
Nazzaro, Lucia
De Anseris, Anna Giulia Elena
Lettieri, Milena
Colantuono, Rossella
Rocco, Maria Chiara
Siano, Maria Anna
Biffaro, Nicola
VAJRO, Pietro
author_sort Paglia, Pamela
collection PubMed
description Hypertransaminasemia in patients with Kawasaki disease (KD) is reported to be transient. Here, we describe a child with an atypically protracted course of liver tests abnormalities and review the inherent literature. The patient was hospitalized at age 7-months for isolated hypertransaminasemia detected during a classical KD diagnosed 3 months before, and persistent since then. KD clinical evolution had been favorable, with rapid response to acetylsalicylic acid and intravenous immunoglobulins. Liver enzymes however remained persistently elevated with a fluctuating pattern (ALT > AST levels; peak of AST 186 IU/L and ALT 240 IU/L). During follow-up, the main causes of liver dysfunction had to be excluded through appropriate and extensive laboratory investigations. Transaminases values become steadily normal only 7 months after the acute presentation of KD. Conclusions: Our report shows that an atypically protracted courses of KD-related hypertransaminasemia above the previously reported temporal limits should be taken into account during the stepwise diagnostic approach to the patient’s liver dysfunction. Insidious acetylsalycilic acid-hepatotoxicity warrants consideration in the differential diagnosis.
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spelling pubmed-82934182021-07-22 Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review Paglia, Pamela Nazzaro, Lucia De Anseris, Anna Giulia Elena Lettieri, Milena Colantuono, Rossella Rocco, Maria Chiara Siano, Maria Anna Biffaro, Nicola VAJRO, Pietro Pediatr Rep Case Report Hypertransaminasemia in patients with Kawasaki disease (KD) is reported to be transient. Here, we describe a child with an atypically protracted course of liver tests abnormalities and review the inherent literature. The patient was hospitalized at age 7-months for isolated hypertransaminasemia detected during a classical KD diagnosed 3 months before, and persistent since then. KD clinical evolution had been favorable, with rapid response to acetylsalicylic acid and intravenous immunoglobulins. Liver enzymes however remained persistently elevated with a fluctuating pattern (ALT > AST levels; peak of AST 186 IU/L and ALT 240 IU/L). During follow-up, the main causes of liver dysfunction had to be excluded through appropriate and extensive laboratory investigations. Transaminases values become steadily normal only 7 months after the acute presentation of KD. Conclusions: Our report shows that an atypically protracted courses of KD-related hypertransaminasemia above the previously reported temporal limits should be taken into account during the stepwise diagnostic approach to the patient’s liver dysfunction. Insidious acetylsalycilic acid-hepatotoxicity warrants consideration in the differential diagnosis. MDPI 2021-07-01 /pmc/articles/PMC8293418/ /pubmed/34287369 http://dx.doi.org/10.3390/pediatric13030044 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Paglia, Pamela
Nazzaro, Lucia
De Anseris, Anna Giulia Elena
Lettieri, Milena
Colantuono, Rossella
Rocco, Maria Chiara
Siano, Maria Anna
Biffaro, Nicola
VAJRO, Pietro
Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review
title Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review
title_full Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review
title_fullStr Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review
title_full_unstemmed Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review
title_short Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review
title_sort atypically protracted course of liver involvement in kawasaki disease. case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293418/
https://www.ncbi.nlm.nih.gov/pubmed/34287369
http://dx.doi.org/10.3390/pediatric13030044
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