MyMedR

Fulltext The late sequalae of coronary artery in a grown up kawasaki disease patient

Yew KL

Med J Malaysia, 2013 Apr;68(2):186.

PMID: 23629576

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome*

Incomplete Kawasaki Disease in a 44-day-old baby

Nor Azizah A, Thong SP, Hung LC

Med J Malaysia, 2018 08;73(4):257-259.

PMID: 30121692 MyJurnal

Kawasaki disease (KD) is an acute systemic vasculitis usually affecting children <5 years old. We report a 44-dayold baby who had persistent fever despite being on antibiotics for presumed sepsis. Erythema of Bacillus Calmette-Guerin (BCG) scar and thrombocytosis were noted on day-2 of illness. Diagnosis of incomplete KD was made on the 10th day of illness. Her fever resolved with intravenous immunoglobulin, but echocardiogram revealed coronary artery aneurysm. High index of suspicion is required to diagnose KD in infants ≤3 months since it is rare and commonly presents with incomplete clinical features. The presence of unexplained fever for ≥5 days with erythema of BCG scar or thrombocytosis in infants should alert the clinicians of KD.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/complications; Mucocutaneous Lymph Node Syndrome/diagnosis*; Mucocutaneous Lymph Node Syndrome/pathology

Fulltext Kawasaki syndrome in Malaysia

Omar A

Med J Malaysia, 1985 Mar;40(1):20-3.

PMID: 3831728

19 cases of Kawasaki Syndrome were seen at the University Hospital, Kuala Lumpur between June 1979 and August 1984. The clinical features of the cases are reviewed in this paper. Kawasaki Syndrome is not an uncommon disease in Malaysia and clinicians should be aware of its presentation.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/diagnosis; Mucocutaneous Lymph Node Syndrome/epidemiology*

A case report of refractory kawasaki disease

Ng SH, Roshan S

Med J Malaysia, 2018 12;73(6):410-412.

PMID: 30647216

Kawasaki disease is an autoimmune disease that commonly affects children below the age of 5 years. It is a vasculitic disease of unknown aetiology effecting the skin, eyes, lymph nodes and mucosal layer. Intravenous Immunoglobulin (IVIG) and aspirin therapy are the mainstay treatment however a number of cases have been shown to be refractory to this treatment. Evidence regarding approach and treatment for such cases is limited. This case report is to share our experience in the management of Refractive Kawasaki disease at a district level.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/diagnosis*; Mucocutaneous Lymph Node Syndrome/drug therapy; Mucocutaneous Lymph Node Syndrome/pathology

Fulltext Measles infection causing Bacillus Calmette-Guérin reactivation: a case report

Muthuvelu S, Lim KS, Huang LY, Chin ST, Mohan A

BMC Pediatr, 2019 07 24;19(1):251.

PMID: 31340782 DOI: 10.1186/s12887-019-1635-z

BACKGROUND: Reactivation of the Bacillus Calmette-Guérin (BCG), manifesting as erythema, induration, ulceration or crust formation at a previous BCG inoculation site, is a common and highly specific feature of Kawasaki disease (KD). We report the unusual finding of BCG reactivation in an infant with laboratory-confirmed measles.

CASE PRESENTATION: A previously healthy 7-month old infant presented initially with fever, cough and coryza, and subsequently developed Koplik's spots followed by a typical morbilliform skin rash. There was significant contact history with a household relative who had recently been diagnosed with measles. On examination, a 2.5 cm area of erythema and induration was seen at the previous BCG inoculation site, in addition to the widespread maculopapular rash. No other clinical features of KD were present. Measles virus was isolated from the throat swab and measles antibodies (IgM) were present in the serum. The patient recovered completely with oral vitamin A and supportive therapy, and had normal echocardiography examination on follow up.

CONCLUSIONS: This case report highlights the rare finding of BCG reactivation in a child with confirmed measles infection, and suggests that this clinical manifestation may occasionally occur in children with infections or conditions other than KD.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/immunology

Mucocutaneous lymph node syndrome in Malaysia

Sinniah D, Nagappan N, Choo M

Med J Malaysia, 1979 Dec;34(2):164-6.

PMID: 548721

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/pathology*

Sudden death in a young adult due to coronary artery aneurysm secondary to suspected Kawasaki disease

Subramaniam S, Boo K

Malays J Pathol, 1992 Jun;14(1):49-51.

PMID: 1469919

A healthy 17-year-old Chinese male suddenly collapsed and died during a game of badminton. The autopsy examination revealed a solitary calcified aneurysm of the left common coronary artery with marked stenosis of the orifices of the anterior descending and circumflex branches. Histology of the aneurysm was non-specific with hyalinised scar tissue and foci of calcification. The only illness of significance in the past was an episode of 'pyrexia of unknown origin' at the age of 8 months. A review of the notes of that hospital admission revealed that the illness was most probably Kawasaki disease.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/complications*; Mucocutaneous Lymph Node Syndrome/pathology

Internal iliac artery thrombosis in a 2-month-old infant with incomplete Kawasaki disease

Musa H, Yubbu P, Koh GT

Cardiol Young, 2020 Jan;30(1):142-144.

PMID: 31679555 DOI: 10.1017/S1047951119002609

We report a case of a 2-month-old infant with incomplete Kawasaki disease with multiple coronary and systemic arteries aneurysms complicated with internal iliac arteries thrombosis. The atypical clinical presentations and severity of systemic vascular involvements discuss the importance of high index of suspicions in younger infants and treatment options in such cases.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/complications*; Mucocutaneous Lymph Node Syndrome/physiopathology

Fulltext Leucocoria in a boy with Kawasaki disease: a diagnostic challenge

Che Mahiran CD, Alagaratnam J, Liza-Sharmini AT

Singapore Med J, 2009 Jul;50(7):e232-4.

PMID: 19644606

Retinoblastoma, the most common primary intraocular malignancy of childhood, usually presents in the first three years of life. Atypical presentation of retinoblastoma can masquerade as virtually any ocular or orbital pathology, which may lead to diagnostic dilemmas especially in the presence of other systemic diseases. We report a 20-month-old boy who was diagnosed with coronary aneurysm as a complication of Kawasaki disease, and presented with sudden left eye redness. His mother noticed the presence of white pupillary reflex three months earlier. Atypical acute ocular presentation secondary to Kawasaki disease was initially suspected, but the presence of multiple calcification and mild proptosis on imaging suggested characteristics of advanced retinoblastoma. Histopathological examination of the enucleated eye, which revealed a classical rosette pattern appearance, confirmed the diagnosis. Atypical presentations of retinoblastoma are usually associated with advanced disease. The presence of other systemic conditions further complicates the diagnosis. Early diagnosis is important to reduce the mortality and morbidity.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/complications; Mucocutaneous Lymph Node Syndrome/diagnosis*

Fulltext Onychomadesis in a 20-Month-Old Child with Kawasaki Disease

Leung AKC, Leong KF, Lam JM

Case Rep Pediatr, 2019;2019:3156736.

PMID: 30944748 DOI: 10.1155/2019/3156736

Kawasaki disease is characterized by fever for ≥ five days, bilateral bulbar conjunctival injection without exudate, polymorphous rash changes in the extremities, oral mucosal changes, and cervical lymphadenopathy. We report a 20-month-old boy with Kawasaki disease who had onychomadesis affecting the fingernails and toenails bilaterally. To our knowledge, there were three reported cases of onychomadesis associated with Kawasaki disease, to which we add another one. We suggest keeping in mind the possibility of onychomadesis as a nail sequela of Kawasaki disease.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome

Kawasaki disease following coronavirus disease 2019 with prolonged fecal viral shedding

Uda K, Okita K, Soneda K, Taniguchi K, Horikoshi Y

Pediatr Int, 2021 05;63(5):597-599.

PMID: 33278321 DOI: 10.1111/ped.14452

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/diagnosis; Mucocutaneous Lymph Node Syndrome/etiology*; Mucocutaneous Lymph Node Syndrome/therapy

Fulltext A young patient with history of Kawasaki disease presenting with triple vessel disease

Lim AL, Lam HY, Kareem BA, Kamarulzaman MH

Med J Malaysia, 2012 Apr;67(2):219-21.

PMID: 22822650 MyJurnal

Kawasaki disease is primarily a condition that affects young children and it is associated with cardiac morbidity and mortality. This disease has been known to cause coronary artery aneurysms which occurs as a sequelae of vasculitis. The progression of triple vessel disease in adult which results from cardiac complications from Kawasaki disease is rare. We report a case of a young man with history of Kawasaki disease at infancy presenting with triple vessel disease requiring cardiac bypass surgery at the age of 20 years old.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome/complications*

Epidemiology and short-term outcome of kawasaki disease in Malaysian children

Hung, Liang Choo

Malaysian Journal of Paediatrics and Child Health, 2007;15(1):28-32.

MyJurnal

Background: Kawasaki Disease (KD) and acute rheumatic fever are the two leading causes of acquired heart disease in children in the developing countries. Objectives: To determine the epidemiology of KD and its short-term outcome in Malaysian children. Materials & Methods: A retrospective study of patients with a diagnosis of KD at the Kuala Lumpur Hospital from January 1999 to December 2003. Results: 84 patients with KD were seen over the 5 year period. Of these, 52 (61.90%) were male and 32 (38.10%) female. Malays comprised 51 (60.71%), Chinese 30 (35.71%) and Indian 3 (3.57%). Their ages ranged from 2 months to 11 years 1 month old. There were 25 (29.76%) patients less than one year old, 50 (59.52%) aged 1-4 years, 4 (4.76%) aged 5-7 years and 5 (5.95%) were more than 7 years old. Echocardiographic examination during the acute phase showed that 24 patients (28.57%) had coronary artery dilatation; 23 had mild dilatation and one had giant aneurysm involving both coronary arteries. Echocardiographic examination at 8 weeks showed that 5 (21.74%) of the 23 patients with mildly dilated coronary arteries had resolved; the bilateral giant coronary aneurysms remained the same. There was no death due to KD over the 5 year period. Conclusion: KD occurred most commonly in children aged 1-4 years old with a peak at 17 months. There was male preponderance with a male to female ratio of 1.6:1. Despite immunoglobulin therapy, 29% of patients had coronary artery involvementduring the acute phase; 22% of those with mild coronary artery dilatation resolved at 8 weeks after disease onset.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome

Fulltext Coronary artery abnormality in complete Kawasaki disease children treated with immunoglobulin

Mohd Amin Itam, Amelia Alias, Mat Bah, M.N.

Malaysian Journal of Paediatrics and Child Health, 2011;17(1):0-0.

MyJurnal

Intravenous immunoglobulin (IVIG) therapy in Kawasaki disease (KD) has been shown to reduce coronary artery aneurysm by 4-5%. However, we still observed significant number of coronary aneurysm post IVIG in our centre. The objectives of this study were to determine the prevalence of coronary artery abnormality (CAA) and the associated risk factors.
Designs: Retrospective descriptive study. Method: A retrospective study performed on children with KD from 1 st January 2005 to 30 th July 2010. Japanese Ministry of Health criteria were used to classify coronary arteries abnormality. Children with incomplete or atypical KD were excluded. Data were extracted from Pediatric Cardiology Clinical Information System.
Results: A total of 126 KD were diagnosed during the study period with 69% were male and 52.4% were Chinese. The median age of diagnosis was 1.4yr [Q1, 0.6yr Q3, 2.3yr]. Of these 126, 118 (93.7%) received IVIG within 10 days of illness. Ten patients (7.9%) required more than one dose of IVIG. CAA were noted in 28 (22.2%) patients with 21 ectasia, 4 small fusiform, one small saccular and 2 medium fusiform aneurysm. Of these 28, 22 who had IVIG within 10 days of illness (18 ectasia, 3 small and one medium coronary aneurysm) Significant risk factors for CAA were older children (2.3 v s 1.7yr, p=0.03), presentation after 10days of illness (p=0.006) and required more than 2gm/kg of IVIG (p=0.04).
Conclusion: CAA in complete KD treated with IVIG was 22.2% with 5.5% significant aneurysm. Risk factors for coronary abnormality were older children, late presentation and require more of IVIG of than 2gm/kg.

Matched MeSH terms: Mucocutaneous Lymph Node Syndrome

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