title: A girl with extremely refractory Kawasaki disease: an instructive case with unusual course and outcome.
abstract: Kawasaki disease constitutes an acute febrile vasculitis of unknown aetiology. It is considered the most common cause of acquired cardiac failure in children. Although standard treatment comprises intravenous immunoglobulin and aspirin, some children exhibit refractory disease, necessitating the use of alternative therapies such as corticosteroids and anti-tumour necrosis factor-alpha. For these cases, few controlled data are available. This report focuses on an extremely refractory classical Kawasaki disease with coronary artery aneurysms and ongoing inflammation. We discuss the therapeutic approaches and the potential pitfalls undertaken, which led to an unfavourable clinical outcome.
authors.affiliation: Second Department of Pediatrics, P&A Kyriakou Children's Hospital, University of Athens, 12 Korieou Str., Athens, Greece. lydiakossiva@hotmail.com
authors.forename: Lydia
authors.initials: L
authors.lastname: Kossiva
authors.forename: Kossiva
authors.initials: K
authors.lastname: Lydia
authors.forename: Evangelos
authors.initials: E
authors.lastname: Karanassios
authors.forename: Karanassios
authors.initials: K
authors.lastname: Evangelos
authors.forename: George
authors.initials: G
authors.lastname: Papadopoulos
authors.forename: Papadopoulos
authors.initials: P
authors.lastname: George
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Karavanaki
authors.forename: Karavanaki
authors.initials: K
authors.lastname: Kyriaki
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology*; D004452:Echocardiography; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D007223:Infant; D007249:Inflammation; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017202:Myocardial Ischemia / Q000209:etiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D001241:Aspirin