Shock: an unusual presentation of Kawasaki disease

Abstract

Diagnosis of KD could be missed in the pediatric intensive care unit because of its atypical presentation and the wide array of associated clinical symptoms. Subsequently, intensivists and emergency room physicians should maintain a high index of suspicion not to miss it or diagnose it at an advanced stage of the illness.

Kawasaki disease: an unexpected etiology of shock and multiple organ dysfunction syndrome

“…Shock and severe myocardial dysfunction are rarely reported in the acute stage of KD [6,7,[21][22][23][24]. The hypothesis of proinflammatory cytokine overexpression in KD leading to myocyte contractile dysfunction and subsequently regulated by IVIG has been proposed by some authors [25].…”

An atypical presentation of Kawasaki disease: a 10-year-old boy with acute exudative tonsillitis and bilateral cervical lymphadenitis

“…Indeed, recent case reports have highlighted atypical cases of KD involving patients presenting with symptoms such as severe shock (7) and pancreatitis (8). A recent case series has also highlighted the existence of KD in adults, indicating that age is not a defining characteristic of the disease (9).…”

What dose of intravenous immunoglobulin should be administered in Kawasaki disease with suspected systemic capillary leak syndrome?

“…Dear Editor, We read with great interest the contribution by Thabet et al [6]. They reported an unusual case of Kawasaki disease (KD) presenting with hypotensive shock in a 5-month-old infant.…”

“…Notably, Thabet et al administered a moderate dose (1 g/kg) of IVIG to the patient instead of a high dose (2 g/kg) [6]. The efficacy of a moderate dose of IVIG in preventing coronary artery abnormality (CAA) was lower than that of the high-dose regimen reported previously [2].…”