PMID- 31770238
OWN - NLM
STAT- MEDLINE
DCOM- 20191206
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 98
IP  - 48
DP  - 2019 Nov
TI  - Atypical manifestations of cardiomegaly and nephrotic syndrome in Kawasaki 
      disease: Two case reports.
PG  - e18117
LID - 10.1097/MD.0000000000018117 [doi]
LID - e18117
AB  - RATIONALE: To examine atypical manifestations of Kawasaki disease (KD) in 
      children. BACKGROUND: Cardiovascular complications during acute KD are a major 
      contributor to its mortality rate. It can involve the pericardium, the 
      myocardium, the endocardium, and/or the coronary arteries; however, cardiomegaly 
      and nephrotic syndrome (NS) during the acute stage of KD have seldom been 
      reported. PATIENT CONCERNS: Two children, each with a fever lasting more than 5 
      days, were diagnosed with cardiomegaly using echocardiography in the early phase 
      of Kawasaki disease (within 2 weeks). Case 1 was misdiagnosed with NS because of 
      the proteinuria, hypoalbuminemia, and edema present at the onset of the disease. 
      DIAGNOSES: A diagnosis of incomplete KD was based on a constellation of clinical 
      manifestations and symptoms and was supported by laboratory results. 
      INTERVENTIONS: Intravenous immunoglobulin (IVIG) and aspirin were administered, 
      supplemented with and without supplemental steroid therapy (case dependent). 
      OUTCOMES: The clinical manifestations and syndromes of the two cases were 
      completely resolved and their heart size restored to normal within 2 weeks, with 
      no evidence of coronary artery lesions (CAL). MAIN LESSONS: Physical findings and 
      manifestations are atypical in incomplete KD. Cardiomegaly and nephrotic syndrome 
      can be an early manifestation of KD; cardiomegaly, especially, should be 
      recognized as a possible manifestation of the acute stage of KD. Furthermore, 
      these symptoms can be rapidly relieved by treatment with IVIG, with or without 
      supplemental steroid therapy.
FAU - Wang, Liyuan
AU  - Wang L
AD  - Department of Pediatrics, West China Second University Hospital.
AD  - Key Laboratory of Obstetric & Gynaecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan, 
      China.
FAU - Sun, Xiaomei
AU  - Sun X
AD  - Department of Pediatrics, West China Second University Hospital.
AD  - Key Laboratory of Obstetric & Gynaecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan, 
      China.
FAU - Cai, Xiaotang
AU  - Cai X
AD  - Department of Pediatrics, West China Second University Hospital.
AD  - Key Laboratory of Obstetric & Gynaecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan, 
      China.
FAU - Liu, Shunli
AU  - Liu S
AD  - Department of Pediatrics, West China Second University Hospital.
AD  - Key Laboratory of Obstetric & Gynaecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan, 
      China.
FAU - Wang, Zhiling
AU  - Wang Z
AD  - Department of Pediatrics, West China Second University Hospital.
AD  - Key Laboratory of Obstetric & Gynaecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan, 
      China.
FAU - Xie, Yongmei
AU  - Xie Y
AD  - Department of Pediatrics, West China Second University Hospital.
AD  - Key Laboratory of Obstetric & Gynaecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, 610041, Sichuan, 
      China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Cardiomegaly/*etiology/pathology
MH  - Child
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Mucocutaneous Lymph Node Syndrome/*complications/pathology
MH  - Nephrotic Syndrome/*etiology/pathology
PMC - PMC6890282
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2019/11/27 06:00
MHDA- 2019/12/18 06:00
PMCR- 2019/11/27
CRDT- 2019/11/27 06:00
PHST- 2019/11/27 06:00 [entrez]
PHST- 2019/11/27 06:00 [pubmed]
PHST- 2019/12/18 06:00 [medline]
PHST- 2019/11/27 00:00 [pmc-release]
AID - 00005792-201911290-00047 [pii]
AID - MD-D-19-02616 [pii]
AID - 10.1097/MD.0000000000018117 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2019 Nov;98(48):e18117. doi: 10.1097/MD.0000000000018117.