Kawasaki disease presenting with lymphadenopathy and gastrointestinal hemorrhage: report of one case.

Abstract

We report a 5-year-old boy with Kawasaki disease (KD) initially presenting with cervical lymphadenitis and complicated by gastrointestinal hemorrhage before the use of salicylates (aspirin). A previously well and fully immunized 5-year-old Japanese boy presented with a 5-day history of neck mass and fever. Physical examination showed bilateral lymphadenopathy but not nonexudative conjunctivitis, oral cavity changes, skin rash, or extremity changes. He was admitted with a diagnosis of neck lymphadenitis and treated with parenteral antibiotics. Tarry stool was noted on the second day of admission, before the definitive diagnosis of KD was made, and cimetidine was given to treat the gastrointestinal hemorrhage. On the fourth day of admission, he fulfilled the diagnostic criteria for KD (fever for 9 days plus lymphadenopathy, lip fissure, conjunctivitis, and skin rash). He was treated with intravenous immunoglobulin (2 g/kg/day) and aspirin (80 mg/kg/day), and the fever subsided promptly. Massive gastrointestinal bleeding occurred on the ninth day of admission and was treated with whole blood transfusion, after which the vital signs were stable.

• Authors: Chien-Hsi Chang, Ming-Hua Chen, Winnie Yang
• Journal: Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi (Acta Paediatr Taiwan) 2004 May-Jun Vol. 45 Issue 3 Pg. 171-3 ISSN: 1608-8115 [Print] China (Republic : 1949- )
• PMID: 15493738 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulins, Intravenous
• Aspirin

Topics

• Aspirin (therapeutic use)
• Child, Preschool
• Gastrointestinal Hemorrhage (etiology)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Japan
• Lymphatic Diseases (etiology)
• Male
• Mucocutaneous Lymph Node Syndrome (complications, diagnosis, drug therapy)
• Radiography, Abdominal
• Treatment Outcome