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A four-time-recurring typical complete Kawasaki syndrome successfully treated with intravenous immunoglobulin: a case report with literature review

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Abstract

Kawasaki syndrome (KS) typically strikes children younger than age 5 and presents with persistent high fever for at least 5 days combined with a heterogeneous polymorphous rash, extremity abnormalities, oropharyngitis, non-exudative conjunctivitis and cervical lymphadenitis. Treatment with high-dose intravenous immunoglobulin reduces substantially the risk of potential cardiovascular complications. For the first time, we report a child presenting all the clinical symptoms of KS, which recurred for 4 times in a period of 33 months. Each relapse was characterized by obstinate high fever combined with mucocutaneous signs and was each time successfully treated with intravenous immunoglobulin without the occurrence of any cardiovascular damage.

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References

  1. Kawasaki T, Kosaki F, Osawa S, Shigematsu I, Yanagawa H (1974) A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics 54:271–276

    PubMed  CAS  Google Scholar 

  2. De Rosa G, Pardeo M, Rigante D (2007) Current recommendations for the pharmacologic therapy in Kawasaki syndrome and management of its cardiovascular complications. Eur Rev Med Pharmacol Sci 11:301–308

    PubMed  Google Scholar 

  3. Burns JC, Mason WH, Glode MP, Shulman ST, Melish ME, Meissner C, Bastian J, Beiser AS, Meyerson HM, Newburger JW (1991) Clinical and epidemiologic characteristics of patients referred for evaluation of possible Kawasaki disease. J Pediatr 118:680–686

    Article  PubMed  CAS  Google Scholar 

  4. Rigante D, Valentini P, Rizzo D, Leo A, De Rosa G, Onesimo R, De Nisco A, Angelone DF, Compagnone A, Delogu AB (2010) Responsiveness to intravenous immunoglobulins and occurrence of coronary artery abnormalities in a single-centre cohort of Italian patients with Kawasaki syndrome. Rheumatol Int 30:841–846

    Article  PubMed  CAS  Google Scholar 

  5. Yanagawa H, Nakamura Y, Yashiro M, Ojima T, Koyanagi H, Kawasaki T (1996) Update of the epidemiology of Kawasaki disease in Japan–from the results of 1993–94 nationwide survey. J Epidemiol 6:148–157

    Article  PubMed  CAS  Google Scholar 

  6. Falcini F, Capannini S, Rigante D (2011) Kawasaki syndrome: an intriguing disease with numerous unsolved dilemmas. Pediatr Rheumatol Online J 20:9–17

    Google Scholar 

  7. Vargo TA, Huhta JC, Moore WH, Person DA, Edwards MS (1986) Recurrent Kawasaki disease. Pediatr Cardiol 6:199–202

    Article  PubMed  CAS  Google Scholar 

  8. Lee KY, Han JW, Lee JS (2007) Kawasaki disease may be a hyperimmune reaction of genetically susceptible children to variants of normal environmental flora. Med Hypotheses 69:642–651

    Article  PubMed  CAS  Google Scholar 

  9. Nakamura Y, Oki I, Tanihara S, Ojima T, Yanagawa H (1998) Cardiac sequelae in recurrent cases of Kawasaki disease: a comparison between the initial episode of the disease and a recurrence in the same patients. Pediatrics 102:E66

    Article  PubMed  CAS  Google Scholar 

  10. Hirata S, Nakamura Y, Yanagawa H (2001) Incidence rate of recurrent Kawasaki disease and related risk factors: from the results of nationwide surveys of Kawasaki disease in Japan. Acta Paediatr 90:40–44

    Article  PubMed  CAS  Google Scholar 

  11. Broderick L, Tremoulet AH, Burns JC, Bastian JF, Hoffman HM (2011) Recurrent fever syndromes in patients after recovery from Kawasaki syndrome. Pediatrics 127:e489–e493

    Article  PubMed  Google Scholar 

  12. Blanchard JN, Powell HC, Freeman WR, Letendre S, Blanchard D, Shimizu C, Burns JC (2003) Recurrent Kawasaki disease-like syndrome in a patient with acquired immunodeficiency syndrome. Clin Infect Dis 36:105–111

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Transition Clinic, University of Florence, Florence, Italy

    Fernanda Falcini

  2. Department of Pediatrics, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d’Aragona, Presidio Ospedale Cava de’ Tirreni, Salerno, Italy

    Grazia D’Adamo

  3. Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy

    Donato Rigante

Authors
  1. Fernanda Falcini
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  2. Grazia D’Adamo
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  3. Donato Rigante
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Correspondence to Donato Rigante.

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Falcini, F., D’Adamo, G. & Rigante, D. A four-time-recurring typical complete Kawasaki syndrome successfully treated with intravenous immunoglobulin: a case report with literature review. Rheumatol Int 33, 2653–2655 (2013). https://doi.org/10.1007/s00296-012-2485-2

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  • DOI: https://doi.org/10.1007/s00296-012-2485-2

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