Asymptomatic cerebral infarction in Kawasaki disease

Fujiwara, Seiji; Yamano, Tsunekazu; Hattori, Masanori; Fujiseki, Y; Shimada, Morimi

doi:10.1016/0887-8994(92)90077-c

Cited by 33 publications

(16 citation statements)

References 7 publications

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“…Other neurological manifestations such as intense irritability, seizures, ataxia, lethargy or coma, subdural collection, hemiplegia, facial palsy and sensorineural hearing loss can also be detected in approximately 1.3 to 3.7% of cases [9,10]. CNS lesions should always be considered, especially in severe cases accompanied by intense and prolonged inflammatory activity [11]. …”

Section: Discussionmentioning

confidence: 99%

Catastrophic Kawasaki disease unresponsive to IVIG in a 3-month-old infant: a diagnostic and therapeutic challenge

Magalhães¹,

Alves²,

Melo³

et al. 2012

Pediatr Rheumatol

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The present report describes the severe evolution of Kawasaki disease in a three-month-old infant. The ailment was initially atypical in its presentation, with the patient exhibiting only persistent fever in association with a progressive lethargy and maculopapular rash on the face, trunk and limbs erroneously diagnosed as roseola infantum. On the 10th day of the condition, mainly due to the unexplained persistence of fever, the infant was admitted to a local hospital. The typical features of KD appeared only on the 14th day of illness with the relapse of the maculopapular rash in association with non-purulent conjunctivitis; dry, reddish and fissured lips; tongue with reddish and hypertrophic papillae; erythema and edema of the palms and soles. During the following days, the ailment rapidly evolved to a catastrophic clinical picture characterized by generalized vasculitis, splenic infarction, pulmonary thrombosis, giant right and left coronary aneurysms, dilatation of common and internal iliac arteries and progressive ischemia of the distal third of the feet resulting in necrotic lesions of both halluces. Appropriate therapy was initiated, but repeated administration of intravenous immunoglobulin G (IVIG) followed by three days of administration of methylprednisolone did not abate the intense inflammatory activity. The remission of inflammation and regression of vascular lesions were only achieved during the following five weeks after the introduction of methotrexate associated with etanercept. The report of this case aims to draw attention to severe forms of KD that exhibit an unfavorable evolution and can be extremely refractory to the conventional therapy.

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Section: Discussionmentioning

confidence: 99%

Catastrophic Kawasaki disease unresponsive to IVIG in a 3-month-old infant: a diagnostic and therapeutic challenge

Magalhães¹,

Alves²,

Melo³

et al. 2012

Pediatr Rheumatol

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“…Both generalized 3,7 and localized [7][8][9][10][11][12][13][14][15] CNS symptoms have been reported in Kawasaki disease. Autopsy findings have shown varying degrees of inflammatory changes in brain vasculature, which are usually less extensive than coronary artery involvement.…”

Section: Cognitive Academic and Behavioral Outcomesmentioning

confidence: 99%

The Effect of Kawasaki Disease on Cognition and Behavior

Wj¹,

Schlieper²,

Birdi³

et al. 2000

Arch Pediatr Adolesc Med

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“…Neurological complications, including cerebral infarction, aseptic meningitis, facial palsy, sensorineural hearing loss, hemiparesis, ataxia, and encephalopathy, have been previously reported. [5][6][7][8][9][10][11] We performed single-photon emission computed tomography (SPECT) in children with KD to investigate brain perfusion in the acute stage.…”

mentioning

confidence: 99%

Cerebral Hypoperfusion During Acute Kawasaki Disease

Ichiyama

Nishikawa

Hayashi

et al. 1998

Stroke

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Background and Purpose-Kawasaki disease is a febrile disease of children notable for systemic vasculitis. There have been many previous reports of various complications, including disorders of the central nervous system. We evaluated cerebral perfusion during the acute stage in patients with Kawasaki disease. Methods-Single-photon emission-computed tomography (SPECT) with 99m Tc-hexamethylpropyleneamine oxime was performed in 21 children with acute stage Kawasaki disease. Follow-up SPECT and MRI were performed about 1 month after the first SPECT in patients who exhibited abnormal SPECT findings during the acute stage. Results-In 6 of 21 children SPECT imaging demonstrated localized cerebral hypoperfusion without abnormal neurological findings or clinical symptoms, and the follow-up SPECT and MRI approximately 1 month after the first SPECT revealed no abnormalities. Conclusions-Some patients with Kawasaki disease have transient localized cerebral hypoperfusion at the acute stage.

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Asymptomatic cerebral infarction in Kawasaki disease

Cited by 33 publications

References 7 publications

Catastrophic Kawasaki disease unresponsive to IVIG in a 3-month-old infant: a diagnostic and therapeutic challenge

Catastrophic Kawasaki disease unresponsive to IVIG in a 3-month-old infant: a diagnostic and therapeutic challenge

The Effect of Kawasaki Disease on Cognition and Behavior

Cerebral Hypoperfusion During Acute Kawasaki Disease

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