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Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease

Introduction: Kawasaki disease (KD) is an acute systemic vasculitis in children, but 0.4% of patients with KD exhibit central nervous system involvement. Acute encephalitis and encephalopathy accompanied with KD have been reported to be mostly self-limiting complications. Case Presentation: A 2-year...

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Autores principales: Maeda, Kenichi, Chong, Pin Fee, Akamine, Satoshi, Yamashita, Fumiya, Morooka, Yuya, Mori, Harushi, Lee, Sooyoung, Mizuno, Yumi, Kira, Ryutaro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8484865/
https://www.ncbi.nlm.nih.gov/pubmed/34604143
http://dx.doi.org/10.3389/fped.2021.732110
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author Maeda, Kenichi
Chong, Pin Fee
Akamine, Satoshi
Yamashita, Fumiya
Morooka, Yuya
Mori, Harushi
Lee, Sooyoung
Mizuno, Yumi
Kira, Ryutaro
author_facet Maeda, Kenichi
Chong, Pin Fee
Akamine, Satoshi
Yamashita, Fumiya
Morooka, Yuya
Mori, Harushi
Lee, Sooyoung
Mizuno, Yumi
Kira, Ryutaro
author_sort Maeda, Kenichi
collection PubMed
description Introduction: Kawasaki disease (KD) is an acute systemic vasculitis in children, but 0.4% of patients with KD exhibit central nervous system involvement. Acute encephalitis and encephalopathy accompanied with KD have been reported to be mostly self-limiting complications. Case Presentation: A 2-year-old girl developed recurrent vomiting, a cluster of generalized seizures, and decreased consciousness on day 12 after the onset of KD. Magnetic resonance imaging (MRI) T2-weighted images on day 13 showed high signal intensities in bilaterally symmetrical and subcortical white matter and thalamus, and linear radial hyperintensities parallel to the cerebral vessels of the periventricular white matter. Diffuse white matter hyperintensity on the apparent diffusion coefficient map suggested vasogenic edema. Subsequently, lethal cerebral edema rapidly progressed in 8 hrs after the MRI examination. Conclusion: To our knowledge, acute fulminant cerebral edema in patients with KD has not been previously reported. We should be aware of the possibility of severe encephalitis related to KD. Furthermore, diffuse white matter vasogenic edema with perivascular abnormalities on MRI may be an alerm, potentially leading to fatal cerebral edema.
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spelling pubmed-84848652021-10-02 Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease Maeda, Kenichi Chong, Pin Fee Akamine, Satoshi Yamashita, Fumiya Morooka, Yuya Mori, Harushi Lee, Sooyoung Mizuno, Yumi Kira, Ryutaro Front Pediatr Pediatrics Introduction: Kawasaki disease (KD) is an acute systemic vasculitis in children, but 0.4% of patients with KD exhibit central nervous system involvement. Acute encephalitis and encephalopathy accompanied with KD have been reported to be mostly self-limiting complications. Case Presentation: A 2-year-old girl developed recurrent vomiting, a cluster of generalized seizures, and decreased consciousness on day 12 after the onset of KD. Magnetic resonance imaging (MRI) T2-weighted images on day 13 showed high signal intensities in bilaterally symmetrical and subcortical white matter and thalamus, and linear radial hyperintensities parallel to the cerebral vessels of the periventricular white matter. Diffuse white matter hyperintensity on the apparent diffusion coefficient map suggested vasogenic edema. Subsequently, lethal cerebral edema rapidly progressed in 8 hrs after the MRI examination. Conclusion: To our knowledge, acute fulminant cerebral edema in patients with KD has not been previously reported. We should be aware of the possibility of severe encephalitis related to KD. Furthermore, diffuse white matter vasogenic edema with perivascular abnormalities on MRI may be an alerm, potentially leading to fatal cerebral edema. Frontiers Media S.A. 2021-09-17 /pmc/articles/PMC8484865/ /pubmed/34604143 http://dx.doi.org/10.3389/fped.2021.732110 Text en Copyright © 2021 Maeda, Chong, Akamine, Yamashita, Morooka, Mori, Lee, Mizuno and Kira. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Maeda, Kenichi
Chong, Pin Fee
Akamine, Satoshi
Yamashita, Fumiya
Morooka, Yuya
Mori, Harushi
Lee, Sooyoung
Mizuno, Yumi
Kira, Ryutaro
Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease
title Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease
title_full Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease
title_fullStr Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease
title_full_unstemmed Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease
title_short Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease
title_sort case report: acute fulminant cerebral edema with perivascular abnormalities related to kawasaki disease
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8484865/
https://www.ncbi.nlm.nih.gov/pubmed/34604143
http://dx.doi.org/10.3389/fped.2021.732110
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