Jaundice-predominant manifestation of Kawasaki disease in children
BackgroundA jaundice-predominant presentation of Kawasaki disease (KD) is atypical.MethodsA total of 12 children with KD with a predominant manifestation of jaundice at MacKay Children's Hospital were reviewed, along with 42 cases reported in the literature since 1990.ResultsThe median age of t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1281909/full |
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| author | Ya-Ning Huang Ya-Ning Huang Chien-Yu Lin Chien-Yu Lin Chien-Yu Lin Hsin Chi Hsin Chi Nan-Chang Chiu Nan-Chang Chiu Daniel Tsung-Ning Huang Daniel Tsung-Ning Huang Lung Chang Lung Chang Lung Chang Yen-Hsin Kung Yen-Hsin Kung Ching-Ying Huang Ching-Ying Huang |
| author_facet | Ya-Ning Huang Ya-Ning Huang Chien-Yu Lin Chien-Yu Lin Chien-Yu Lin Hsin Chi Hsin Chi Nan-Chang Chiu Nan-Chang Chiu Daniel Tsung-Ning Huang Daniel Tsung-Ning Huang Lung Chang Lung Chang Lung Chang Yen-Hsin Kung Yen-Hsin Kung Ching-Ying Huang Ching-Ying Huang |
| author_sort | Ya-Ning Huang |
| collection | DOAJ |
| description | BackgroundA jaundice-predominant presentation of Kawasaki disease (KD) is atypical.MethodsA total of 12 children with KD with a predominant manifestation of jaundice at MacKay Children's Hospital were reviewed, along with 42 cases reported in the literature since 1990.ResultsThe median age of the 12 patients was 1.85 years (range: 3 months–4 years), and 66.6% were male. All of the patients had elevated liver function at presentation, 50% had hydrops of the gallbladder, and almost 60% had gastrointestinal symptoms and signs. Complete KD was evident in 11 of the 12 patients (91.7%), and two patients (16.7%) had recurrent episodes. All of the patients received intravenous immunoglobulin (IVIG); however, one-third were refractory to treatment. Corticosteroids were used in five (41.7%) of the patients. Three (25%) of the patients had shock, and seven (58.3%) had coronary artery abnormalities, of whom one (8.3%) had persistent coronary artery aneurysm and the others recovered. A review of the 42 cases in the literature showed that the children with a jaundice-predominant presentation of KD had high rates of IVIG-refractory disease (25%), coronary artery abnormalities (25%), shock (13.2%), and corticosteroid treatment (24.2%).ConclusionsChildren with KD presenting with a jaundice-predominant manifestation are at a higher risk of IVIG-refractory disease, coronary artery abnormalities, and more recurrent episodes. Physicians should be aware of the risk of shock in this population. |
| first_indexed | 2024-03-08T15:51:49Z |
| format | Article |
| id | doaj.art-8c45d4eda33a429791d0053d17a31fd3 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-08T15:51:49Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-8c45d4eda33a429791d0053d17a31fd32024-01-09T04:26:24ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602024-01-011110.3389/fped.2023.12819091281909Jaundice-predominant manifestation of Kawasaki disease in childrenYa-Ning Huang0Ya-Ning Huang1Chien-Yu Lin2Chien-Yu Lin3Chien-Yu Lin4Hsin Chi5Hsin Chi6Nan-Chang Chiu7Nan-Chang Chiu8Daniel Tsung-Ning Huang9Daniel Tsung-Ning Huang10Lung Chang11Lung Chang12Lung Chang13Yen-Hsin Kung14Yen-Hsin Kung15Ching-Ying Huang16Ching-Ying Huang17Department of Pediatrics, Hsinchu Municipal MacKay Children’s Hospital, Hsinchu, TaiwanDepartment of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanDepartment of Pediatrics, Hsinchu Municipal MacKay Children’s Hospital, Hsinchu, TaiwanDepartment of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanDepartment of Medicine, MacKay Medicine College, Taipei, TaiwanDepartment of Medicine, MacKay Medicine College, Taipei, TaiwanDepartment of Pediatric Infectious Diseases, MacKay Children’s Hospital, Taipei, TaiwanDepartment of Medicine, MacKay Medicine College, Taipei, TaiwanDepartment of Pediatric Infectious Diseases, MacKay Children’s Hospital, Taipei, TaiwanDepartment of Medicine, MacKay Medicine College, Taipei, TaiwanDepartment of Pediatric Infectious Diseases, MacKay Children’s Hospital, Taipei, TaiwanDepartment of Medicine, MacKay Medicine College, Taipei, TaiwanDepartment of Pediatric Infectious Diseases, MacKay Children’s Hospital, Taipei, TaiwanDepartment of Pediatrics, Tamshui MacKay Memorial Hospital, Taipei, TaiwanDepartment of Pediatric Infectious Diseases, MacKay Children’s Hospital, Taipei, TaiwanDepartment of Pediatrics, Tamshui MacKay Memorial Hospital, Taipei, TaiwanDepartment of Medicine, MacKay Medicine College, Taipei, TaiwanDepartment of Pediatric Infectious Diseases, MacKay Children’s Hospital, Taipei, TaiwanBackgroundA jaundice-predominant presentation of Kawasaki disease (KD) is atypical.MethodsA total of 12 children with KD with a predominant manifestation of jaundice at MacKay Children's Hospital were reviewed, along with 42 cases reported in the literature since 1990.ResultsThe median age of the 12 patients was 1.85 years (range: 3 months–4 years), and 66.6% were male. All of the patients had elevated liver function at presentation, 50% had hydrops of the gallbladder, and almost 60% had gastrointestinal symptoms and signs. Complete KD was evident in 11 of the 12 patients (91.7%), and two patients (16.7%) had recurrent episodes. All of the patients received intravenous immunoglobulin (IVIG); however, one-third were refractory to treatment. Corticosteroids were used in five (41.7%) of the patients. Three (25%) of the patients had shock, and seven (58.3%) had coronary artery abnormalities, of whom one (8.3%) had persistent coronary artery aneurysm and the others recovered. A review of the 42 cases in the literature showed that the children with a jaundice-predominant presentation of KD had high rates of IVIG-refractory disease (25%), coronary artery abnormalities (25%), shock (13.2%), and corticosteroid treatment (24.2%).ConclusionsChildren with KD presenting with a jaundice-predominant manifestation are at a higher risk of IVIG-refractory disease, coronary artery abnormalities, and more recurrent episodes. Physicians should be aware of the risk of shock in this population.https://www.frontiersin.org/articles/10.3389/fped.2023.1281909/fulljaundiceIVIG-refractory diseaseKawasaki diseasechildrenhyperbilirubinemia |
| spellingShingle | Ya-Ning Huang Ya-Ning Huang Chien-Yu Lin Chien-Yu Lin Chien-Yu Lin Hsin Chi Hsin Chi Nan-Chang Chiu Nan-Chang Chiu Daniel Tsung-Ning Huang Daniel Tsung-Ning Huang Lung Chang Lung Chang Lung Chang Yen-Hsin Kung Yen-Hsin Kung Ching-Ying Huang Ching-Ying Huang Jaundice-predominant manifestation of Kawasaki disease in children Frontiers in Pediatrics jaundice IVIG-refractory disease Kawasaki disease children hyperbilirubinemia |
| title | Jaundice-predominant manifestation of Kawasaki disease in children |
| title_full | Jaundice-predominant manifestation of Kawasaki disease in children |
| title_fullStr | Jaundice-predominant manifestation of Kawasaki disease in children |
| title_full_unstemmed | Jaundice-predominant manifestation of Kawasaki disease in children |
| title_short | Jaundice-predominant manifestation of Kawasaki disease in children |
| title_sort | jaundice predominant manifestation of kawasaki disease in children |
| topic | jaundice IVIG-refractory disease Kawasaki disease children hyperbilirubinemia |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1281909/full |
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