Case Report: Lower Limb Muscle Weakness in a Child With Kawasaki Disease

Huang, Lilin; Peng, Shumei; Li, Jing; Xie, Dong

doi:10.3389/fped.2022.893568

Cited by 2 publications

(2 citation statements)

References 31 publications

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“…[ 4 ]. To date, 11 cases of children with KD have been reported with combined muscular weakness, mainly characterized by difficulty in walking, ptosis, ocular dyskinesia, respiratory failure, dysphonia and dysphagia [ 5 – 15 ]. The objective of the study is to report a child diagnosed with IKD combined with Kawasaki disease shock syndrome (KDSS), characterized by muscular weakness of the extremities and the bladder and bowel retention abnormalities, who was effectively treated with gammaglobulin, aspirin, and steroid, which has not been reported previously.…”

Section: Introductionmentioning

confidence: 99%

Incomplete Kawasaki disease with muscular weakness and bladder retention: a case report

Sang,

Luo,

Qiao

2024

BMC Pediatr

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Background Kawasaki disease (KD) is an acute systemic immune vasculitis affecting multiple organs and systems in children, and is prevalent in children under 5 years of age. Muscular weakness is a rare manifestation of KD, and only 11 pediatric patients with KD combined with muscular weakness have been reported, of which evidence of myositis was found in 2/3 of the patients, and 1/3 could not be explained by myositis, the mechanism of which is still unclear. Cases of KD combined with bladder retention are even more rare, and there has been only 1 case report of KD combined with bladder retention in a child with no previous underlying disease. Case presentation We report a 22-month-old Asian child with incomplete Kawasaki disease (IKD) who initially presented with fever and progressive muscular weakness in the lower extremities, followed by the bladder and bowel retention abnormalities and rapid onset of heart failure, respiratory failure and shock. The child developed coronary artery ectasia (CAA) without the main clinical features of KD such as rash, conjunctival congestion, desquamation of the extremity endings, orofacial changes and enlarged lymph nodes in the neck. Creatine kinase and electromyography were normal. Temperature gradually normalized and muscle strength recovered slightly after intravenous immunoglobulin. The child could be helped to walk after 1 week of aspirin combined with steroid therapy. Conclusions We present the case of a 22-month-old child with IKD. The child began with progressive muscular weakness in the extremities, followed by the bladder and bowel retention abnormalities, and rapidly developed heart failure, respiratory failure, and shock. Despite early failure to detect the disease, the child recovered rapidly and had a favorable prognosis. KD comorbidities with muscular weakness as the main manifestation are uncommon. This is the first case report of IKD combined with both muscular weakness and bladder and bowel retention, which may provide clinicians with diagnostic and therapeutic ideas, as well as a basis for future exploration of the mechanisms of KD combined with muscular weakness or bladder and bowel retention abnormalities.

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Section: Introductionmentioning

confidence: 99%

Incomplete Kawasaki disease with muscular weakness and bladder retention: a case report

Sang,

Luo,

Qiao

2024

BMC Pediatr

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“…[4] . To date, 11 cases of children with KD have been reported with combined muscle weakness, mainly characterized by di culty in walking, ptosis, ocular dyskinesia, respiratory failure, dysphonia and dysphagia [5][6][7][8][9][10][11][12][13][14][15] . The objective of the study is to report a child with atypical severe Kawasaki disease, characterized by muscle weakness of the extremities and urinary and fecal retention, who was effectively treated with gammaglobulin, aspirin, and methylprednisolone, which has not been reported previously.…”

Section: Introductionmentioning

confidence: 99%

Severe Kawasaki disease with muscle weakness and urinary retention: A case report

Sang,

Luo,

Qiao

2023

Preprint

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Background Kawasaki disease (KD) is an acute systemic immune vasculitis affecting multiple organs and systems in children, and is prevalent in children under 5 years of age. Myasthenia gravis is a rare manifestation of KD, and only 11 pediatric patients with KD combined with myasthenia gravis have been reported, of which evidence of myasthenia gravis was found in 2/3 of the patients, and 1/3 could not be explained by myasthenia gravis, the mechanism of which is still unclear.Cases of KD combined with urinary retention are even more rare, and there has been only 1 case report of KD combined with urinary retention in a child with no previous underlying disease. Case presentation: We report a 22-month-old Asian child with severe KD who initially presented with fever and muscle weakness in the lower extremities, which progressed to progressive muscle weakness in the extremities, followed by urinary and fecal retention and rapid onset of heart failure, respiratory failure and shock. The child developed coronary artery dilatation without the main clinical features of Kawasaki disease such as rash, conjunctival congestion, desquamation of the extremity endings, orofacial changes and enlarged lymph nodes in the neck. Muscle enzymes and electromyography were normal. Temperature gradually normalized and muscle strength recovered slightly after intravenous immunoglobulin. The child could be helped to walk after 1 week of aspirin combined with prednisone therapy. Conclusions We present the case of a 22-month-old child with severe KD. The child began with progressive muscle weakness in the extremities, followed by urinary and fecal retention, and rapidly developed heart failure, expiratory failure, and shock. Despite early failure to detect the disease, the child recovered rapidly and had a favorable prognosis. KD comorbidities with muscle weakness as the main manifestation are uncommon. This is the first case report of severe Kawasaki disease combined with both muscle weakness and rectal bladder dysfunction, which may provide clinicians with diagnostic and therapeutic ideas, as well as a basis for future exploration of the mechanisms of KD combined with muscle weakness or urinary retention.

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Case Report: Lower Limb Muscle Weakness in a Child With Kawasaki Disease

Cited by 2 publications

References 31 publications

Incomplete Kawasaki disease with muscular weakness and bladder retention: a case report

Incomplete Kawasaki disease with muscular weakness and bladder retention: a case report

Severe Kawasaki disease with muscle weakness and urinary retention: A case report

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