PMID- 33204972
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231112
IS  - 2514-2119 (Electronic)
IS  - 2514-2119 (Linking)
VI  - 4
IP  - 5
DP  - 2020 Oct
TI  - Adolescent Kawasaki disease shock syndrome with inflammatory cell infiltration 
      into the myocardium: a case report.
PG  - 1-7
LID - 10.1093/ehjcr/ytaa304 [doi]
AB  - BACKGROUND: Kawasaki disease (KD) is a self-limiting form of systemic vasculitis. 
      KD usually occurs in infants and young children and is rarely seen in 
      adolescents. On rare occasions, KD is accompanied with reduced organ perfusion 
      due to systolic hypotension, a condition known as Kawasaki disease shock syndrome 
      (KDSS). The multifactorial causes of KDSS may include intensive vasculitis with 
      capillary leak, myocardial dysfunction, and release of proinflammatory cytokines. 
      However, the mechanisms underlying the pathophysiology of KDSS have not been 
      fully elucidated. CASE SUMMARY: A febrile 17-year-old male with cervical 
      lymphadenopathy developed extreme shock with rapid cardiac dysfunction and 
      reduced organ perfusion. Electrocardiogram revealed ST elevation in the 
      precordial leads and increased serum levels of cardiac enzyme levels. 
      Endomyocardial biopsy at the acute phase revealed CD3(+), CD4(+) or CD8(+), and 
      CD20(-) lymphocytes and CD68(+) macrophages within infiltrates in the myocardium 
      with mild interstitial fibrosis. He was treated with intravenous immunoglobulin 
      (IVIG) and followed by glucocorticoids with mechanical circulatory support. His 
      cardiac function recovered rapidly with no apparent adverse effects. DISCUSSION: 
      Our results suggest that KDSS may be a form of myocarditis, a condition in which 
      inflammatory cells infiltrate the myocardium. Early immunosuppressive therapy, 
      including IVIG and glucocorticoid therapy, may limit the severity of disease and 
      improve the prognosis. As shown by this case, an accurate diagnosis of KD and 
      KDSS will lead to early intervention and improved prognosis even among those in 
      an older cohort.
CI  - (c) The Author(s) 2020. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Sugiura, Yuki
AU  - Sugiura Y
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, 65 
      Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan.
FAU - Okumura, Takahiro
AU  - Okumura T
AUID- ORCID: 0000-0001-5076-2052
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, 65 
      Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan.
FAU - Kondo, Toru
AU  - Kondo T
AUID- ORCID: 0000-0001-6853-7574
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, 65 
      Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan.
FAU - Murohara, Toyoaki
AU  - Murohara T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, 65 
      Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan.
LA  - eng
PT  - Case Reports
DEP - 20200909
PL  - England
TA  - Eur Heart J Case Rep
JT  - European heart journal. Case reports
JID - 101730741
PMC - PMC7649480
OTO - NOTNLM
OT  - Case report
OT  - Endomyocardial biopsy
OT  - Immunosuppressive therapy
OT  - Inflammatory cell
OT  - Kawasaki disease
OT  - Shock
EDAT- 2020/11/19 06:00
MHDA- 2020/11/19 06:01
PMCR- 2020/09/09
CRDT- 2020/11/18 06:01
PHST- 2020/03/30 00:00 [received]
PHST- 2020/05/18 00:00 [revised]
PHST- 2020/08/07 00:00 [accepted]
PHST- 2020/11/18 06:01 [entrez]
PHST- 2020/11/19 06:00 [pubmed]
PHST- 2020/11/19 06:01 [medline]
PHST- 2020/09/09 00:00 [pmc-release]
AID - ytaa304 [pii]
AID - 10.1093/ehjcr/ytaa304 [doi]
PST - epublish
SO  - Eur Heart J Case Rep. 2020 Sep 9;4(5):1-7. doi: 10.1093/ehjcr/ytaa304. 
      eCollection 2020 Oct.