Pulse methylprednisolone therapy for impending cardiac tamponade in immunoglobulin-resistant Kawasaki disease.
We describe a boy with Kawasaki disease (KD) whose clinical course was marked by a rapid improvement upon treatment with intravenous immunoglobulin (IVIG) and oral aspirin, which - within 14 days - was followed by the development of a large pericardial effusion with symptoms of impending cardiac tamponade as part of a polyserositis syndrome (pleural effusions, ascites). Upon treatment with pulsed methylprednisolone, the pericardial and pleural effusions and ascites rapidly disappeared within 48 h. This is the first case reported with a polyserositis syndrome and impending cardiac tamponade during KD.
Dahlem
P G
PG
Division of Pediatric Intensive Care, Department of Pediatrics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. P.Dahlem@amc.uva.nl
von Rosenstiel
I A
IA
Lam
J
J
Kuijpers
T W
TW
D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D002648:Child; D003937:Diagnosis, Differential; D018450:Disease Progression; D004334:Drug Administration Schedule; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016756:Immunoglobulins, Intravenous; D001241:Aspirin; D008775:Methylprednisolone