Atypical Kawasaki Disease- Dilatation of Ascending Aorta and Peripheral Gangrene

Soni, Jai Prakash; Makwana, Mohan; Jetha, Kapil; Mantri, Anoop

doi:10.18410/jebmh/2017/265

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…We have found 19 similar case reports of Kawasaki patients with gangrene and a total of 24 patients in previously published Medline-indexed literatures ( Table 1 ) (unavailable data are presented with question marks in the table content). The average age of the reported patients was 5 months, although a 4-year-old and a 22-year-old with Kawasaki and gangrene were reported as well [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment with PGE1 and prostacyclin seems to have positive effects on reperfusion. However, treatment is only effective if started early in therapy [ 11 , 13 , 15 – 17 ]. von Planta et al mentioned that their patient developed myocardial infarction after prostaglandin infusion and raise the concern that this might steal perfusion and cause ischemia in compromised coronary arteries of KD patients [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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Peripheral Gangerene, an Unusual Presentation of Infantile Kawasaki: A Case Report and Literature Review

Tahghighi

Koohsorkhi

Ziaee

2021

Case Reports in Rheumatology

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Introduction. Diagnosing infantile Kawasaki disease with atypical symptoms is difficult, and it also has higher risk of coronary abnormalities which is one of the most common complications of KD. Other complications such as pericardial effusion, mitral insufficiency, congestive heart failure, myocardial systolic dysfunction, and systemic vasculitis were also reported. Peripheral gangrene and necrosis are among the rare complications of this systemic vasculitis. Case Presentation. We report an 8-month-old girl with prolonged fever, generalized petechial rash, cracked erythematous lips, edema, and coronary ectasia who received two doses of IVIG in another center, but short after her discharge, she started to develop a necrotic plaque on her knee. She was admitted in our hospital, and the repeat echocardiography showed sustained coronary ectasia. She received 3 doses of methylprednisolone pulse therapy and was discharged with aspirin and prednisolone. In the follow-up visits, the coronary ectasia was resolved and the necrotic ulcer was healing with a scar. Conclusions. The diagnosis of Kawasaki disease and echocardiographic evaluation of the coronary arteries should be considered in young infants with prolonged fever of unknown origin. Peripheral gangrene is a rare but important complication of infantile Kawasaki disease, although the exact mechanism in not fully understood.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Peripheral Gangerene, an Unusual Presentation of Infantile Kawasaki: A Case Report and Literature Review

Tahghighi

Koohsorkhi

Ziaee

2021

Case Reports in Rheumatology

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“…At the same time, we performed a right upper limb artery ultrasound examination and echocardiography, and no obvious embolism or thrombosis was found. By reviewing the relevant literature, we found that 25 patients with KD presented with complications of peripheral gangrene [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], Therefore we believe that this peripheral thrombosis was related to KD.…”

Section: Case Presentationmentioning

confidence: 99%

Kawasaki disease complicated by peripheral artery thrombosis: a case report and literature review

Zhang

Xiong

et al. 2022

Pediatr Rheumatol

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Background Peripheral gangrene is rarely documented as a possible complication of Kawasaki disease (KD). There are many causes of peripheral gangrene, and the common cause is in situ thrombosis or embolism. Most cases are reported to have regrettable outcomes (amputation or necrotic shedding). Herein, we report the successful management of KD complicated by peripheral artery thrombosis in an older Chinese boy, and a review of all cases of peripheral gangrene in KD in the literature. Case presentation We found that most of the children with this complication were under 1 year old, had a heavy inflammatory response combined with the use of cortisol and immunoglobulin, and most children had coronary artery lesions. In addition, Peripheral gangrene mainly occurred in the subacute or chronic stage, and the prognosis is poor. Conclusions In the presence of high risk factors, we consider it is necessary to monitor coagulation function and administer prophylactic anticoagulation therapy. When peripheral artery thrombosis or embolism occur, heparin and prostaglandins can be used for treatment.

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Kawasaki Disease with Peripheral Gangrene in Children: A Case Series and Review of Literature

Sidharth

Mahajan

Maheshwari

et al. 2022

Journal of Tropical Pediatrics

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Kawasaki disease (KD) is a medium vessel vasculitis of childhood particularly affecting the coronary arteries and leads to aneurysms in 15–25% of untreated patients. It is a rare cause of peripheral limb gangrene in children under 5 years. Most of the cases in literature are reported during infancy. The median age of KD in patients with gangrene is 3 months and the median time for onset of signs of ischaemic necrosis is 2–4 weeks after the diagnosis and often leads to amputation of the affected limb. Even with early treatment, salvaging the limb is difficult and often not successful. There is an acute risk of mortality and long-term morbidity if the underlying inflammatory process is not identified and treated in a timely manner. We present four cases of KD, who had peripheral limb gangrene at the time of presentation. Initial workup for infective aetiology and pro-coagulant state were negative. Diagnosis of peripheral limb gangrene secondary to atypical KD was made on the basis of echocardiography and laboratory findings.

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Atypical Kawasaki Disease- Dilatation of Ascending Aorta and Peripheral Gangrene

Cited by 4 publications

References 17 publications

Peripheral Gangerene, an Unusual Presentation of Infantile Kawasaki: A Case Report and Literature Review

Peripheral Gangerene, an Unusual Presentation of Infantile Kawasaki: A Case Report and Literature Review

Kawasaki disease complicated by peripheral artery thrombosis: a case report and literature review

Kawasaki Disease with Peripheral Gangrene in Children: A Case Series and Review of Literature

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