A case of Kawasaki disease presenting as sigmoid colitis

Ohnishi, Yasuhiro; Mori, Kazuhiro; Inoue, Miki; Satake, Nobuo; Yano, Mitsuyasu

doi:10.1007/s10396-017-0808-3

Cited by 7 publications

(9 citation statements)

References 11 publications

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“…2,5,13,16,17,[20][21][22]24,33 The outcome was good in 28 patients (57%, including the 3 patients who did not receive medical treatment). 4,6,12,17,19,[21][22][23][24]27,[29][30][31][32][33][34] Seven patients (14%) showed persistence of CAAs, 5,15,16,20,21 and 1 (2%) patient developed cyanosis, and later, left hand and forefoot gangrene. 3 Three patients (6%) died: in 1 case autopsy revealed massive liver necrosis and progressive duodenal infarction with systemic arteritis and periarteritis involving vessels of all sizes 3 ; the second patient died 2 days after the exploratory laparotomy 2 ; the third patient died because of Pseudomonas septic shock.…”

Section: Resultsmentioning

confidence: 99%

Intestinal Involvement in Kawasaki Disease

Colomba

Placa

Saporito

et al. 2018

The Journal of Pediatrics

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The diagnosis and treatment of Kawasaki disease might be delayed if intestinal symptoms appear before the characteristic clinical features of Kawasaki disease, thus, increasing the risk of cardiac complications. Furthermore, patients may undergo unnecessary invasive procedures. Pediatricians and pediatric surgeons, therefore, should consider Kawasaki disease among diagnoses in children with fever, abdominal symptoms, and radiologic findings of pseudo-obstruction.

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Section: Resultsmentioning

confidence: 99%

Intestinal Involvement in Kawasaki Disease

Colomba

Placa

Saporito

et al. 2018

The Journal of Pediatrics

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“…Abdominal ultrasound, a computed tomography scan and colonoscopy showed severe thickening of the sigmoid colon. The boy subsequently exhibited typical symptoms of Kawasaki disease and was successfully treated with intravenous immunoglobulins 23 . Several studies have reported hepatobiliary dysfunctions, including hepatitis, cholangitis, jaundice or significantly elevated aminotransferase in Kawasaki disease 22‐24 .…”

Section: Resultsmentioning

confidence: 99%

“…19,22 Abdominal distension, paralytic ileus, hepatomegaly and hydrops of ease. [22][23][24] Hydrops of the gallbladder has been frequently described.…”

Section: Gastrointestinal Featuresmentioning

confidence: 99%

Gastrointestinal involvement in childhood vasculitides

2020

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Aim: The aim of this narrative review was to provide a comprehensive summary of the characteristics of gastrointestinal (GI) involvement in the most common paediatric primary vasculitides. Methods: We used PubMed to primarily identify papers, reviews, case series and editorials published in English from 2000 until 31 January 2020. Based on this, we report the prevalence, clinical manifestations, diagnostic approaches and management of GI involvement in each vasculitis. Results: Vasculitides are inflammatory blood vessel diseases, and the majority can affect the GI system with vascular, GI tract or solid organ involvement. GI involvement can sometimes complicate and delay the correct diagnosis. Clinical findings are usually nonspecific symptoms, such as fever, abdominal pain, nausea, vomiting and diarrhoea. Bleeding should alert paediatricians to the possibility of severe complicated vasculitis. Diagnosis relies mostly on imaging. If it goes unrecognised, GI involvement in paediatric vasculitis is a serious cause of morbidity and even mortality, related to bowel ischaemia and perforation. Treatment of GI symptoms depends on the type of vasculitis and usually involves high-dose steroids and immunosuppressants. Conclusion: GI manifestations in the most common paediatric primary vasculitides were usually nonspecific, diagnosis mostly relied on imaging, and treatment usually involved high-dose corticosteroids and immunosuppressants. K E Y W O R D S childhood, gastrointestinal involvement, immunosuppressant, steroids, vasculitis | 2227 TRAPANI eT Al. paralytic ileus, mesenteric ischaemia, bowel obstruction and perforation. Occasionally, GI involvement can be the presenting feature, and this can complicate and delay the correct diagnosis. The aim of this narrative review was to provide a comprehensive summary and update of the characteristics of GI involvement in the most common paediatric primary vasculitis. 2 | ME THODS We used PubMed to primarily identify papers, reviews, case series and editorials published in English from 2000 until 31 January 2020. The keywords included the following: IgA vasculitis, Henoch-Schonlein purpura, Kawasaki disease, Behcet disease, polyarteritis nodosa, Takayasu arteritis, deficiency of adenosine deaminase 2, antineutrophilic cytoplasmic antibodies-associated vasculitis, gastrointestinal, gut, child and paediatric or paediatric.

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“…Except for the typical five clinical features, KD could have multiple other manifestations including arthritis, aseptic meningitis, colitis, etc [9][10][11] . Indeed, KD in early stage with atypical manifestations often leads to misdiagnosis.…”

Section: Discussionmentioning

confidence: 99%

The cerebrospinal fluid changes and clinical characteristics of aseptic meningitis in Kawasaki disease

Hu¹,

Shi²,

Fan³

et al. 2020

Preprint

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Background: Aseptic meningitis is not a common feature in Kawasaki disease (KD). However, it could cause difficulty in making correct and in-time diagnosis Methods: We retrospectively investigated patients of KD and bacterial meningitis (BM). Totally 38 KD patients and 126 BM patients were brought into this study. Clinical symptoms, signs and laboratory examinations were compared between the two groups, which included: duration of fever before lumbar puncture, conjunctiva injection, oral cavity change, rash, cervical lymphadenopathy and extremities change, vomiting, front fontanel bulging, neck stiffness, leukocytes, hemoglobin, platelets, C-reactive protein, cerebrospinal fluid examinations, liver function and urinalysis. Results: In clinical signs, vomit and neck stiffness were more prevalent in BM. KD patients showed higher blood leukocyte (p<0.001) and C-reactive protein (p<0.001) in the early febrile stage. Glucose in cerebrospinal fluid of BM patients was significantly lower than KD patients (p=0.003). In ROC curve, the optimal cutoff value of CSF glucose was 2.945mmol/L with the sensitivity of 84.2% and specificity of 71.4%. Pyuria was more prevalent in KD patients (p<0.001). There was no significant difference in front fontanel bulging, hemoglobin, platelet, alanine transaminase, aspartate transaminase, albumin, cerebrospinal fluid leukocytes, cerebrospinal fluid protein and cerebrospinal fluid lactate dehydrogenase. Conclusions ： Full investigation of clinical manifestation and laboratory tests is necessary to distinguish KD with aseptic meningitis and BM. In CSF study, glucose level is more efficient than other items to distinguish these two diseases. Decreased CSF glucose is possibly an indicator of BM rather than KD.

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A case of Kawasaki disease presenting as sigmoid colitis

Cited by 7 publications

References 11 publications

Intestinal Involvement in Kawasaki Disease

Intestinal Involvement in Kawasaki Disease

Gastrointestinal involvement in childhood vasculitides

The cerebrospinal fluid changes and clinical characteristics of aseptic meningitis in Kawasaki disease

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