Acute cholestasis: atypical onset of Kawasaki disease.
Atypical onset of Kawasaki disease (KD) is a frequent problem leading to diagnostic mistake. Acute cholestasis and liver involvement occur occasionally as minor manifestation of KD. We report the case of a 6-year-old boy presenting fever, jaundice, abdominal pain, and ascites who subsequently developed typical KD clinical pattern just at the same time of echocardiographic coronary arteries anomalies. Abdominal radiological evaluation was normal and seroimmunologic markers resulted negative. Shortly after intravenous immunoglobulin and acetylsalicylic acid administration the clinical features disappeared. KD should be considered in differential diagnosis in children with cholestasis, abdominal pain and fever of unknown etiology.
Department of Pediatrics, A. Gemelli University Hospital, Catholic University of the Sacred Heart, Largo Gemelli 8, 00168 Rome, Italy. pvalentini@rm.unicatt.it
P
P
Valentini
E
E
Ausili
A
A
Schiavino
D F
DF
Angelone
B
B
Focarelli
G
G
De Rosa
O
O
Ranno
D000208:Acute Disease; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002648:Child; D002779:Cholestasis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D003937:Diagnosis, Differential; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D001241:Aspirin