Hasan, Taufiq Hidayat and Syed Ahmad Shihabuddin Abdurrahman Alsagoff, Sharifah Aishah and Yusoff, Muhammad Khairul Amri
(2021)
Doctor, is it incomplete Kawasaki disease? A case report.
In: Indonesian Pediatric Congress (KONIKA), Medan.
(Unpublished)
Abstract
Background: Kawasaki Disease (KD) is an acute systemic vascular disease that affects medium sized vessels. It is the most common cause of acquired heart disease in children. Incomplete KD is established if clinical presentation suggestive for KD but not meeting the full diagnostic criteria. Objective of this case report is to present a difficult case of incomplete KD with normal echo findings that give good response to IVIG and aspirin treatment.
Case: A 10-month-old girl had history of high grade fever for 6 days and persistent despite 5 days of antibiotic. There were generalized maculopapular rashes, edema and erythema of hands and feet, and shotty cervical lymph node. Otherwise there were no conjunctivitis or mucosal changes. Echocardiography was normal but the C-reactive protein and erythrocyte sedimentation rate were increased. There were leucocytosis, anemia, thrombocytopenia, raised liver tranaminases, and hypoalbuminemia. Abdominal ultrasound showed distended gallbladder with thickened wall. After started IVIG and aspirin, fever was resolved and patient was discharged.
Conclusion: In case of incomplete KD with normal echocardiogram, positive three supplemental criteria such as increased CRP or ESR, leucocytosis, anemia, thrombocytosis, hypoalbuminemia, increased liver transaminase, and leucocyturia is can be used to establish diagnosis and start treatment.
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