Kawasaki disease with predominant central nervous system involvement

Tabarki, Brahim; Mahdhaoui, Abdallah; Selmi, H.; Yacoub, M.; Essoussi, A. S.

doi:10.1016/s0887-8994(01)00290-9

Cited by 61 publications

(33 citation statements)

References 12 publications

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“…Aseptic meningitis has been generally described as an event that occurs during the acute phase of KD [7,8]. Other neurological manifestations such as intense irritability, seizures, ataxia, lethargy or coma, subdural collection, hemiplegia, facial palsy and sensorineural hearing loss can also be detected in approximately 1.3 to 3.7% of cases [9,10]. CNS lesions should always be considered, especially in severe cases accompanied by intense and prolonged inflammatory activity [11].…”

Section: Discussionmentioning

confidence: 99%

Catastrophic Kawasaki disease unresponsive to IVIG in a 3-month-old infant: a diagnostic and therapeutic challenge

Magalhães¹,

Alves²,

Melo³

et al. 2012

Pediatr Rheumatol

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The present report describes the severe evolution of Kawasaki disease in a three-month-old infant. The ailment was initially atypical in its presentation, with the patient exhibiting only persistent fever in association with a progressive lethargy and maculopapular rash on the face, trunk and limbs erroneously diagnosed as roseola infantum. On the 10th day of the condition, mainly due to the unexplained persistence of fever, the infant was admitted to a local hospital. The typical features of KD appeared only on the 14th day of illness with the relapse of the maculopapular rash in association with non-purulent conjunctivitis; dry, reddish and fissured lips; tongue with reddish and hypertrophic papillae; erythema and edema of the palms and soles. During the following days, the ailment rapidly evolved to a catastrophic clinical picture characterized by generalized vasculitis, splenic infarction, pulmonary thrombosis, giant right and left coronary aneurysms, dilatation of common and internal iliac arteries and progressive ischemia of the distal third of the feet resulting in necrotic lesions of both halluces. Appropriate therapy was initiated, but repeated administration of intravenous immunoglobulin G (IVIG) followed by three days of administration of methylprednisolone did not abate the intense inflammatory activity. The remission of inflammation and regression of vascular lesions were only achieved during the following five weeks after the introduction of methotrexate associated with etanercept. The report of this case aims to draw attention to severe forms of KD that exhibit an unfavorable evolution and can be extremely refractory to the conventional therapy.

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Section: Discussionmentioning

confidence: 99%

Catastrophic Kawasaki disease unresponsive to IVIG in a 3-month-old infant: a diagnostic and therapeutic challenge

Magalhães¹,

Alves²,

Melo³

et al. 2012

Pediatr Rheumatol

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“…The most important complication of KD is coronary arterial aneurysms (in 15-25% of untreated children), which may cause ischemic heart disease and sudden death [1,2]. Irritability, lethargy, transient unilateral facial nerve palsy are sometimes observed, and pleocytosis in the cerebrospinal fluid (CSF) is found in around 40% [1][2][3][4], however, febrile convulsions and acute encephalopathy are extremely rare [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Kawasaki disease complicated by mild encephalopathy with a reversible splenial lesion (MERS)

Takanashi

Shirai

Sugawara

et al. 2012

Journal of the Neurological Sciences

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“…Cerebrospinal fluid pleocytosis and increased cytokine levels, similar to those reported in encephalitis, are also observed in Kawasaki disease and reflect intracranial inflammation that is possibly responsible for the characteristic irritability 2 3. Predominantly neurological presentations of Kawasaki disease are well described and include focal cranial nerve palsies,4 encephalopathy5 and meningoencephalitis 6 7…”

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confidence: 72%