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OP-028 Interesting cases of incomplete Kawasaki syndrome
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  1. Virag Egri,
  2. Beata Visy,
  3. Laszlo Szabo
  1. Heim Pál National Pediatric Institute

Abstract

Aim Kawasaki Syndrome is the second most common vasculitis in children under 5 years of age. In an increasing percentage of cases, especially in younger children, the disease does not complete the major diagnostic criteria, and the atypical presentation delays treatment. Furthermore, it increases the risk of coronary aneurysm as a serious complication. In our case report, we have reviewed four cases of unusual Kawasaki Syndrome from the past two years of our Infectology Department. The ages of our patients ranged from ten weeks to 2.5 years. Only one of them was admitted from our emergency department with a possible diagnosis of Kawasaki Syndrome, other cases were indicated for sepsis and suspected urinary tract infection. On assessment in our emergency department, all children were febrile and had skin symptoms. Conjunctivitis, cheilitis, and lymphadenopathy were present in one case. At the beginning, the first laboratory test showed elevated CRP in all cases, associated with leukocytosis and thrombocytosis in two cases, and anemia in one case. The first urinalysis showed pyuria in two cases. During the whole course of the disease, among major criteria, fever for five days long, rash, and conjunctivitis were present in all children. There were two cases with mucosal symptoms, one case of edema of extremities, and one case of lymphadenopathy up to 1.5 cm. Hypalbuminaemia was present in all cases, requiring albumin supplementation on two occasions. In all cases, thrombocytosis was seen after the seventh day of illness. Anemia developed in three cases, requiring transfusion in one case. Three cases showed pyuria. Coronary involvement developed in one case. In conclusion, the major diagnostic requirements were incomplete in all of the cases. It is important in the presence of fever and rash lasting several days to consider the possibility of Kawasaki Syndrome.

  • Kawasaki
  • Incomplete Kawasaki Disease
  • fever
  • rush

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