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A 3 year 6 month-old child with high fever for 4 days, bilateral non-purulent conjunctivitis, rash in the upper and lower limbs regressed within 72 h, lymphadenitis in the left mandibular corner, edema on the soles of her feet and limping, was admitted to the Pediatric Medical Department of our hospital. Blood tests showed abnormal values for C-reactive protein (CRP) [14.11 mg/dL; normal level (nl): 0-0.5 mg/dL], white blood cell (WBC) (17.13 x 10³/uL; nl:4-14 x 10³/uL), Neutrophil % (82.7%; nl: 10-74 %), Platelet count (467 x 10³/uL; nl: 150-450 x 10³/uL), Cholesterol (107 mg/dL; nl: 120-200 mg/dL), Triglycerides (156 mg/dL; nl:40-150 mg/dL); normal vascular parameters for haemoglobin (Hb) (11,4 g/dL; nl: 9-16 g/dL), Albumin (3.8 g/dL; nl: 3,5-5,5 g/dL), glutamic pyruvic transaminase (GPT) (15 UI/L; nl: 5-40 UI/L) and glutamic oxaloacetic transaminase (GOT) (24 UI/L; nl: 5-40 UI/L). The diagnosis of typical Kawasaki’s disease was made based on persistent fever associated with 4 positive diagnostic clinical criteria. Echocardiogram was found to be negative for coronary dilatation, and treatment with intravenous Immunoglogulins (IVIG) (2 g/kg) and acetylsalycilic Acid (ASA) (80 mg/kg) was started. Because of the persistence of the hyperpyrexia after 48 h a second IVIG bolus was performed and after another 48 h 3 boluses of steroids were delivered, after which all symptoms regressed. Therefore, the child was discharged in good general health conditions on a regimen with ASA at antiaggregant doses (5 mg/kg). Four weeks later, fever appeared again with arthralgia in the lower limbs.

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2014-02-28   |   468 visitas   |   Evalua este artículo 0 valoraciones

Vol. 13 Núm.2. Marzo-Abril 2014 Pags. 284-287 Ann Hepatol 2014; 13(2)