Incomplete Kawasaki syndrome followed by systemic onset-juvenile idiopathic arthritis mimicking Kawasaki syndrome.
A 3-month-old child was first treated for incomplete Kawasaki syndrome with three cycles of intravenous immunoglobulins and aspirin, then with methylprednisolone which led to fever remission. The same child was re-hospitalized after a 10-month-period of well-being for the suspicion of a new episode of Kawasaki syndrome, which appeared to be immunoglobulin-resistant: extensive testing failed to provide an alternative diagnosis of any infectious or infiltrative disease. Diagnosis of systemic onset-juvenile idiopathic arthritis was postulated upon the long persistence of fever and inflammatory signs, which subsided only after starting corticosteroid treatment.
Rigante
Donato
D
Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Largo A. Gemelli no. 8, Rome, Italy. drigante@gmail.com
Valentini
Piero
P
Onesimo
Roberta
R
Angelone
Donatella Francesca
DF
De Nisco
Alessia
A
Bersani
Giulia
G
Delogu
Angelica Bibiana
AB
D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D005938:Glucocorticoids; D011241:Prednisone