Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease
Introduction: Kawasaki disease (KD) is an acute systemic vasculitis in children, but 0.4% of patients with KD exhibit central nervous system involvement. Acute encephalitis and encephalopathy accompanied with KD have been reported to be mostly self-limiting complications.Case Presentation: A 2-year-...
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2021.732110/full |
| _version_ | 1818641079998611456 |
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| author | Kenichi Maeda Pin Fee Chong Pin Fee Chong Satoshi Akamine Fumiya Yamashita Yuya Morooka Harushi Mori Sooyoung Lee Yumi Mizuno Ryutaro Kira |
| author_facet | Kenichi Maeda Pin Fee Chong Pin Fee Chong Satoshi Akamine Fumiya Yamashita Yuya Morooka Harushi Mori Sooyoung Lee Yumi Mizuno Ryutaro Kira |
| author_sort | Kenichi Maeda |
| collection | DOAJ |
| description | Introduction: Kawasaki disease (KD) is an acute systemic vasculitis in children, but 0.4% of patients with KD exhibit central nervous system involvement. Acute encephalitis and encephalopathy accompanied with KD have been reported to be mostly self-limiting complications.Case Presentation: A 2-year-old girl developed recurrent vomiting, a cluster of generalized seizures, and decreased consciousness on day 12 after the onset of KD. Magnetic resonance imaging (MRI) T2-weighted images on day 13 showed high signal intensities in bilaterally symmetrical and subcortical white matter and thalamus, and linear radial hyperintensities parallel to the cerebral vessels of the periventricular white matter. Diffuse white matter hyperintensity on the apparent diffusion coefficient map suggested vasogenic edema. Subsequently, lethal cerebral edema rapidly progressed in 8 hrs after the MRI examination.Conclusion: To our knowledge, acute fulminant cerebral edema in patients with KD has not been previously reported. We should be aware of the possibility of severe encephalitis related to KD. Furthermore, diffuse white matter vasogenic edema with perivascular abnormalities on MRI may be an alerm, potentially leading to fatal cerebral edema. |
| first_indexed | 2024-12-16T23:21:28Z |
| format | Article |
| id | doaj.art-da3d91c6624840929ea7a817163f76c8 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-16T23:21:28Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-da3d91c6624840929ea7a817163f76c82022-12-21T22:12:09ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-09-01910.3389/fped.2021.732110732110Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki DiseaseKenichi Maeda0Pin Fee Chong1Pin Fee Chong2Satoshi Akamine3Fumiya Yamashita4Yuya Morooka5Harushi Mori6Sooyoung Lee7Yumi Mizuno8Ryutaro Kira9Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, JapanDepartment of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, JapanDepartment of General Pediatrics and Interdisciplinary Medicine, Fukuoka Children's Hospital, Fukuoka, JapanDepartment of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, JapanDepartment of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, JapanDepartment of General Pediatrics and Interdisciplinary Medicine, Fukuoka Children's Hospital, Fukuoka, JapanDepartment of Radiology, School of Medicine, Jichi Medical University, Tochigi, JapanDepartment of Intensive Care, Fukuoka Children's Hospital, Fukuoka, JapanDepartment of Pediatric Infectious Disease, Fukuoka Children's Hospital, Fukuoka, JapanDepartment of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, JapanIntroduction: Kawasaki disease (KD) is an acute systemic vasculitis in children, but 0.4% of patients with KD exhibit central nervous system involvement. Acute encephalitis and encephalopathy accompanied with KD have been reported to be mostly self-limiting complications.Case Presentation: A 2-year-old girl developed recurrent vomiting, a cluster of generalized seizures, and decreased consciousness on day 12 after the onset of KD. Magnetic resonance imaging (MRI) T2-weighted images on day 13 showed high signal intensities in bilaterally symmetrical and subcortical white matter and thalamus, and linear radial hyperintensities parallel to the cerebral vessels of the periventricular white matter. Diffuse white matter hyperintensity on the apparent diffusion coefficient map suggested vasogenic edema. Subsequently, lethal cerebral edema rapidly progressed in 8 hrs after the MRI examination.Conclusion: To our knowledge, acute fulminant cerebral edema in patients with KD has not been previously reported. We should be aware of the possibility of severe encephalitis related to KD. Furthermore, diffuse white matter vasogenic edema with perivascular abnormalities on MRI may be an alerm, potentially leading to fatal cerebral edema.https://www.frontiersin.org/articles/10.3389/fped.2021.732110/fullacute encephalitisperivascular lesionsacute encephalopathyacute fulminant cerebral edemaacute brain swellingvasogenic edema |
| spellingShingle | Kenichi Maeda Pin Fee Chong Pin Fee Chong Satoshi Akamine Fumiya Yamashita Yuya Morooka Harushi Mori Sooyoung Lee Yumi Mizuno Ryutaro Kira Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease Frontiers in Pediatrics acute encephalitis perivascular lesions acute encephalopathy acute fulminant cerebral edema acute brain swelling vasogenic edema |
| title | Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease |
| title_full | Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease |
| title_fullStr | Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease |
| title_full_unstemmed | Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease |
| title_short | Case Report: Acute Fulminant Cerebral Edema With Perivascular Abnormalities Related to Kawasaki Disease |
| title_sort | case report acute fulminant cerebral edema with perivascular abnormalities related to kawasaki disease |
| topic | acute encephalitis perivascular lesions acute encephalopathy acute fulminant cerebral edema acute brain swelling vasogenic edema |
| url | https://www.frontiersin.org/articles/10.3389/fped.2021.732110/full |
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