Abstract
Epidemiological case definition of Kawasaki disease (KD) by the American Heart Association requires the presence of fever and four of the following: eye signs, oral mucosal changes, skin rashes, limb edema, and unilateral cervical lymphadenopathy. Incomplete KD is a well-known entity where there is lack of some of mucocutaneous features, and this occurs more often in infants. We report a 5-year-old boy with KD and giant coronary aneurysms, who presented only with fever and there is complete lack of skin and mucosal manifestations at presentation.
This is a preview of subscription content, log in via an institution to check access.
References
Singh S, Vignesh P, Burgner D (2015) The epidemiology of Kawasaki disease: a global update. Arch Dis Child 100(11):1084–1088. doi:10.1136/archdischild-2014-307536
Kushner HI, Macnee RP, Burns JC (2009) Kawasaki disease in India: increasing awareness or increased incidence? Perspect Biol Med 52(1):17–29. doi:10.1353/pbm.0.0062
Thapa R, Chakrabartty S (2009) Atypical Kawasaki disease with remarkable paucity of signs and symptoms. Rheumatol Int 29(9):1095–1096. doi:10.1007/s00296-009-0899-2
McCrindle BW, Li JS, Minich LL et al (2007) Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation 116(2):174–179. doi:10.1161/CIRCULATIONAHA.107.690875
Newburger JW, Takahashi M, Gerber MA et al (2004) Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 110(17):2747–2771. doi:10.1161/01.CIR.0000145143.19711.78
Ha KS, Jang G, Lee J, Lee K, Hong Y, Son C, Lee J (2013) Incomplete clinical manifestation as a risk factor for coronary artery abnormalities in Kawasaki disease: a meta-analysis. Eur J Pediatr 172(3):343–349. doi:10.1007/s00431-012-1891-5
Sudo D, Monobe Y, Yashiro M, Mieno MN, Uehara R, Tsuchiya K, Sonobe T, Nakamura Y (2012) Coronary artery lesions of incomplete Kawasaki disease: a nationwide survey in Japan. Eur J Pediatr 171(4):651–656. doi:10.1007/s00431-011-1630-3
Maric LS, Knezovic I, Papic N, Mise B, Roglic S, Markovinovic L, Tesovic G (2015) Risk factors for coronary artery abnormalities in children with Kawasaki disease: a 10-year experience. Rheumatol Int 35(6):1053–1058. doi:10.1007/s00296-014-3186-9
Saneeymehri S, Baker K, So TY (2015) Overview of pharmacological treatment options for pediatric patients with refractory Kawasaki disease. J Pediatr Pharmacol Ther 20(3):163–177. doi:10.5863/1551-6776-20.3.163
Youn Y, Kim J, Hong YM, Sohn S (2016) Infliximab as the first retreatment in patients with Kawasaki disease resistant to initial intravenous immunoglobulin. Pediatr Infect Dis J 35(4):457–459. doi:10.1097/INF.0000000000001039
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no potential conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Vignesh, P., Bhattad, S., Singhal, M. et al. A 5-year-old boy with only fever and giant coronary aneurysms: the enigma of Kawasaki disease?. Rheumatol Int 36, 1191–1193 (2016). https://doi.org/10.1007/s00296-016-3490-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-016-3490-7