A case of rectal ulcers during aspirin therapy in acute Kawasaki disease

Abstract

Kawasaki disease (KD) is an acute febrile multisystem vasculitis and has been recognized to be one of the most common causes of acquired heart disease in children. Although gastrointestinal symptoms including vomiting, diarrhea, and abdominal pain are not uncommon in KD patients, KD with lower gastrointestinal bleeding is quite rare. Here, we describe a 3-year-old boy with typical KD who had lower gastrointestinal bleeding caused by rectal ulcers on the third day of aspirin therapy.

A case of gastrointestinal hemorrhage during aspirin therapy in a patient with Kawasaki disease

“…The risks of aspirin therapy are low and appear to be sim-ilar to those reported in other settings, including chemical hepatitis with elevated transaminases, transient hearing loss, dose-related hemolytic anemia [13], and rarely, Reye syndrome. Gastrointestinal hemorrhage is reported in patients administered high-dose aspirin after being diagnosed with KD [3,5]. We describe each cases: a 2-year-old boy diagnosed with KD took aspirin (71 mg/kg/day) during the acute phase and experienced acute gastrointestinal bleeding after 13 days of aspirin treatment.…”

“…A 3-year-old boy who took aspirin (50 mg/kg/day) experienced hematochezia on the third day after taking aspirin. Multiple rectal superficial ulcers were observed in colonoscopy [5]. The cases are summarized in Table 1.…”

“…Gastrointestinal bleeding is rare in patients with KD [3,5,15]. However, attention should be paid to the occurrence of gastrointestinal bleeding.…”

“…Intravenous immunoglobulin (IVIG) and aspirin have been considered as the standard initial treatment of KD for decades [1,2]. Although gastrointestinal hemorrhage is a well-recognized complication of aspirin therapy, it has been previously reported in only a few patients with KD [3][4][5][6]. We describe a patient with typical KD who had massive gastrointestinal bleeding that required hospitalization and transfusion.…”

Platelet-rich plasma for the treatment of chronic rectal ulcer: A case report

“…In addition to solitary rectal ulcers, rectal ulcer can be observed as a symptom in ulcerative colitis, rectal tumors, and ischemic bowel disease, while acute hemorrhagic rectal ulcers, radiation proctitis as well as infectious and drug-induced ones have also been reported. [1][2][3][4][5] At present, topical therapy is the first choice for most patients. The effectiveness of medications, including sulfasalazine, mesalazine, corticosteroids, and sucralfate, has been proven.…”