Ultrasonographic evaluation of the gallbladder in mucocutaneous lymph node syndrome.

Abstract

Hydrops of the gallbladder was diagnosed by ultrasonography in five out of ten consecutive patients with mucocutaneous lymph node syndrome (MLNS). Certain signs and symptoms were correlated with the development of hydrops. Follow-up ultrasonography revealed the return of the gallbladder to normal size in four out of four patients. One patient was lost to follow-up. Hydrops of the gallbladder in patients with MLNS appears to be a self-limiting condition with a benign course.

Sonographic Gallbladder Abnormality Is Associated with Intravenous Immunoglobulin Resistance in Kawasaki Disease

“…However, the group of GBA is associated with a higher level of neutrophils, GPT, and CRP. This finding is comparable with those reported previously in the literature [26, 33, 34]. Of special interest and novel finding is the association between the presence of sonographic GBA with that of initial IVIG resistance.…”

“…The association between KD and hydrops of the gallbladder has been reported as early as the late 1970s and early 1980s in the form of isolated case reports [15, 21, 26, 32–34]. Due to the advent of the gray-scale ultrasound, more and more cases of hydrops of the gallbladder were being diagnosed and recognized as an occasional clinical entity of KD with an incidence rate of 5–14% [14, 15].…”

“…Currently, the etiology behind both AHGB and ACC in KD is unknown, however; common to both is the proposed mechanism of (1) adenopathy around the cystic duct causing obstruction, (2) vasculitis or perivasculitis of the gallbladder wall, and (3) inflammatory infiltrates with polymorphs, lymphocytes, and eosinophils [15, 30, 34, 41]. Previously unaware of the relatively benign and self-limited nature of gallbladder hydrops and acute acalculous cholecystitis in KD, these changes were observed in the pathological specimens of gallbladders resected from KD patients in the late 1980s [15, 28].…”

Renal manifestations of Kawasaki's disease

“…An abdominal radiograph to look for a right upper quadrant soft tissue mass when hydrops of the gallbladder is suspected. Sonography however is recommended as the modality of choice since it will show definitively hydrops of the gallbladder without exposure to ionizing radiation [4][5][6][7]. Barium studies have been used to evaluate intestinal pseudoobstruction [8].…”