Incomplete Kawasaki disease followed by systemic onset juvenile idiopathic arthritis- the diagnostic dilemma.
The authors report an 18-mo-old girl who presented with features of incomplete Kawasaki disease and was refractory to intravenous immunoglobulin and infliximab treatment. She subsequently responded to pulse intravenous methylprednisolone therapy. The diagnostic dilemma arose after 2 mo when she developed clinical features suggestive of systemic onset juvenile idiopathic arthritis. Since both diseases have overlapping clinical features and no specific diagnostic laboratory tests, it is difficult for the clinicians even in the best of centers to reach a definitive diagnosis as illustrated by the index case.
Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Shivani
S
Dogra
Arushi
A
Gehlot
Deepti
D
Suri
Amit
A
Rawat
Rohit Manoj
RM
Kumar
Surjit
S
Singh
D000284:Administration, Oral; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology; D006801:Humans; D007116:Immunization, Passive; D007223:Infant; D000069285:Infliximab; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D008775:Methylprednisolone / Q000008:administration & dosage; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D020551:Pulse Therapy, Drug
D000911:Antibodies, Monoclonal; D000069285:Infliximab; D008775:Methylprednisolone