title: Kawasaki disease in a 9-year old girl presenting with febrile cholestasis: case report and review of literature.
abstract: Kawasaki disease is a systemic vasculitis that develops during childhood, especially in those younger than 5 years. Gastrointestinal involvement does not belong to the classic diagnostic criteria. We reported here, a 9-year old girl who presented with febrile cholestasis, and developed a medium right coronary artery aneurysm despite intravenous immunoglobulin administration on the 9th day of fever. Hepatobiliary ultrasonographic evaluation revealed normal findings. Seroimmunologic markers of cholestasis were negative. Her clinical feature was ameliorated shortly after a second dose of intravenous immunoglobulin administration. We consider that a high index of suspicion of Kawasaki disease could prevent delayed diagnosis and complications.
authors.affiliation: Division of Pediatric Gastroenterology, Hepatology and Nutrition, S. Demirel University School of Medicine, Isparta, Turkey.
authors.forename: Tugba
authors.initials: T
authors.lastname: Koca
authors.affiliation: Department of Pediatrics, S. Demirel University School of Medicine, Isparta, Turkey.
authors.forename: Nagehan
authors.initials: N
authors.lastname: Aslan
authors.affiliation: Division of Pediatric Infectious Diseases, S. Demirel University School of Medicine, Isparta, Turkey.
authors.forename: Aybuke
authors.initials: A
authors.lastname: Akaslan Kara
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Afyon Kocatepe University School of Medicine, Afyon, Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Pektas
authors.affiliation: Division of Pediatric Infectious Diseases, S. Demirel University School of Medicine, Isparta, Turkey.
authors.forename: Metehan
authors.initials: M
authors.lastname: Ozen
authors.affiliation: Division of Pediatric Gastroenterology, Hepatology and Nutrition, S. Demirel University School of Medicine, Isparta, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akcam
mesh_terms: D002648:Child; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology*; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology*; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007155:Immunologic Factors / Q000008:administration & dosage; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011237:Predictive Value of Tests
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors
keywords: Kawasaki disease; acute cholestasis; aneurysm; children