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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-8293418 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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