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An adult case of kawasaki disease in a pregnant Japanese woman: a case report.

Kanno K, Sakai H, Nakajima M, Satake A, Konishi T, Iizuka H - Case Rep Dermatol (2011)

Bottom Line: Bilateral conjunctival congestion, tender cervical lymphadenopathy, an edematous lower lip and peripheral edema followed by desquamation were observed.She was successfully treated with aspirin and intravenous gammaglobulin (1 g/kg/day).Her course was not complicated by coronary artery aneurysm and she delivered a healthy baby.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Asahikawa City Hospital, Asahikawa, Japan.

ABSTRACT
Kawasaki disease is an acute febrile disease predominantly seen in young children. We report a case of Kawasaki disease in a 32-year-old pregnant woman. She developed a generalized erythematous skin rash accompanied by high fever. Bilateral conjunctival congestion, tender cervical lymphadenopathy, an edematous lower lip and peripheral edema followed by desquamation were observed. She was successfully treated with aspirin and intravenous gammaglobulin (1 g/kg/day). Her course was not complicated by coronary artery aneurysm and she delivered a healthy baby. To the best of our knowledge, this is the first case of Kawasaki disease in a pregnant woman. We suggest that Kawasaki disease should be included in the differential diagnosis of a generalized, erythematous skin rash accompanied by high fever in adults.

No MeSH data available.


Related in: MedlinePlus

Confluent, erythematous macules covering almost the entire body.
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Figure 1: Confluent, erythematous macules covering almost the entire body.

Mentions: On admission, physical examination revealed erythematous macules up to 1–2 cm in size covering almost the entire body (fig. 1). Some erythematous plaques had dusky centers that resembled the iris lesion of erythema multiforme (fig. 2). The patient's temperature was 40.0°C. Her pulse was regular at 130 beats/min and blood pressure was 110/60 mm Hg. Her palms and soles were edematous. Bilateral conjunctival congestion, tender cervical lymphadenopathy, and an edematous lower lip were also noted. Examination of the lungs, abdomen and neurologic system did not reveal any abnormal findings. Electrocardiogram and transthoracic echocardiogram were normal. Laboratory investigations revealed an elevated erythrocyte sedimentation rate and C-reactive protein (54.7 mm/h and 5.66 μg/dl, respectively), leukocytosis (12.05 × 109/l), and elevated liver enzymes including aspartate aminotransferase (78 U/l) and alanine aminotransferase (102 U/l). Ferritin was elevated at 1,479.2 ng/ml. No eosinophilia was detected. Analysis of urine revealed 2+ protein, 20–30 white blood cells, and 2+ of bacteria. Blood and urine cultures did not yield growth of pathogenic microorganism. Serological tests for hepatitis B and C, measles, rubella, Epstein-Barr virus, parvovirus B19, cytomegalovirus, Streptococcus, and Mycoplasma showed no evidence of a recent infection. Antinuclear antibodies and anti-neutrophil cytoplasmic antibodies were not detected. Histopathological examination of a skin biopsy showed focal spongiosis, scattered dyskeratotic cells and hydropic degeneration of the epidermis. Perivascular mononuclear lymphocytic infiltrates and extravasation of erythrocytes without vasculitis were also noted.


An adult case of kawasaki disease in a pregnant Japanese woman: a case report.

Kanno K, Sakai H, Nakajima M, Satake A, Konishi T, Iizuka H - Case Rep Dermatol (2011)

Confluent, erythematous macules covering almost the entire body.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3094683&req=5

Figure 1: Confluent, erythematous macules covering almost the entire body.
Mentions: On admission, physical examination revealed erythematous macules up to 1–2 cm in size covering almost the entire body (fig. 1). Some erythematous plaques had dusky centers that resembled the iris lesion of erythema multiforme (fig. 2). The patient's temperature was 40.0°C. Her pulse was regular at 130 beats/min and blood pressure was 110/60 mm Hg. Her palms and soles were edematous. Bilateral conjunctival congestion, tender cervical lymphadenopathy, and an edematous lower lip were also noted. Examination of the lungs, abdomen and neurologic system did not reveal any abnormal findings. Electrocardiogram and transthoracic echocardiogram were normal. Laboratory investigations revealed an elevated erythrocyte sedimentation rate and C-reactive protein (54.7 mm/h and 5.66 μg/dl, respectively), leukocytosis (12.05 × 109/l), and elevated liver enzymes including aspartate aminotransferase (78 U/l) and alanine aminotransferase (102 U/l). Ferritin was elevated at 1,479.2 ng/ml. No eosinophilia was detected. Analysis of urine revealed 2+ protein, 20–30 white blood cells, and 2+ of bacteria. Blood and urine cultures did not yield growth of pathogenic microorganism. Serological tests for hepatitis B and C, measles, rubella, Epstein-Barr virus, parvovirus B19, cytomegalovirus, Streptococcus, and Mycoplasma showed no evidence of a recent infection. Antinuclear antibodies and anti-neutrophil cytoplasmic antibodies were not detected. Histopathological examination of a skin biopsy showed focal spongiosis, scattered dyskeratotic cells and hydropic degeneration of the epidermis. Perivascular mononuclear lymphocytic infiltrates and extravasation of erythrocytes without vasculitis were also noted.

Bottom Line: Bilateral conjunctival congestion, tender cervical lymphadenopathy, an edematous lower lip and peripheral edema followed by desquamation were observed.She was successfully treated with aspirin and intravenous gammaglobulin (1 g/kg/day).Her course was not complicated by coronary artery aneurysm and she delivered a healthy baby.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Asahikawa City Hospital, Asahikawa, Japan.

ABSTRACT
Kawasaki disease is an acute febrile disease predominantly seen in young children. We report a case of Kawasaki disease in a 32-year-old pregnant woman. She developed a generalized erythematous skin rash accompanied by high fever. Bilateral conjunctival congestion, tender cervical lymphadenopathy, an edematous lower lip and peripheral edema followed by desquamation were observed. She was successfully treated with aspirin and intravenous gammaglobulin (1 g/kg/day). Her course was not complicated by coronary artery aneurysm and she delivered a healthy baby. To the best of our knowledge, this is the first case of Kawasaki disease in a pregnant woman. We suggest that Kawasaki disease should be included in the differential diagnosis of a generalized, erythematous skin rash accompanied by high fever in adults.

No MeSH data available.


Related in: MedlinePlus