Kawasaki disease complicated by peripheral gangrene and a ventricular septal defect: An unusual association

Kawasaki disease is an acute febrile illness associated with the vasculitis ofsmall and medium size arteries. Peripheral gangrene is very rare but a knowncomplication of Kawasaki disease mostly reported in the infantile age group.Early therapy is advocated for prevention of serious complications. We reporta 10-month-old girl with Kawasaki disease and a small ventricular septaldefect who developed peripheral gangrene despite initiation of early therapy.

PDF

___

1. Ames EL, Jones JS, Van Dommelen B, Posch JL. Bilateral hand necrosis in Kawasaki syndrome. J Hand Surg Am 1985; 10: 391-395.

2. Belay ED, Maddox RA, Holman RC, Curns AT, Ballah K, Schonberger LB. Kawasaki syndrome and risk factors for coronary artery abnormalities: United States, 1994–2003. Pediatr Infect Dis J 2006; 25: 245-249.

3. Bonté I, Mahr A, Laroche L, Guillevin L, Robineau M. Peripheral gangrene in adult‐onset Kawasaki disease. Scand J Rheumatol 2005; 34: 71-73.

4. Brenner JL, Jadavji T, Pinto A, Trevenen C, Patton D. Severe Kawasaki disease in infants: two fatal cases. Can J Cardiol 2000; 16: 1017-1023.

5. Brogan PA, Bose A, Burgner D, et al. Kawasaki disease: an evidence based approach to diagnosis, treatment, and proposals for future research. Arch Dis Child 2002; 86: 286-290.

6. Chang J-S, Lin J-S, Peng C-T, Tsai C-H. Kawasaki disease complicated by peripheral gangrene. Pediatr Cardiol 1999; 20: 139-142.

7. Dillon MJ, Eleftheriou D, Brogan PA. Medium-sizevessel vasculitis. Pediatr Nephrol 2010; 25: 1641-1652.

8. Durall AL, Phillips JR, Weisse ME, Mullett CJ. Infantile kawasaki disease and peripheral gangrene. Pediatr Crit Care Med 2004; 5: 511. (AAP Abstracts)

9. Gardner-Medwin JM, Dolezalova P, Cummins C, Southwood TR. Incidence of Henoch-Schonlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet 2002; 360: 1197-1202.

10. Harnden A, Alves B, Sheikh A. Rising incidence of Kawasaki disease in England: analysis of hospital admission data. BMJ 2002; 324: 1424-1425.

11. Krohn C, Till H, Haraida S, et al. Multiple intestinal stenoses and peripheral gangrene: a combination of two rare surgical complications in a child with Kawasaki disease. J Pediatr Surg 2001; 36: 651-653.

12. Newburger JW, Takahashi M, Gerber MA, et al; Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease; Council on Cardiovascular Disease in the Young; American Heart Association; American Academy of Pediatrics. Diagnosis, treatment, and longterm management of Kawasaki disease. A statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004; 110: 2747-2771.

13. Teixeira OH, Pong AH, Vlad P. Amputating gangrene in Kawasaki disease. Can Med Assoc J 1982; 127: 132-134.

14. Tomita S, Chung K, Mas M, Gidding S, Shulman ST. Peripheral gangrene associated with Kawasaki disease. Clin Infect Dis 1992; 14: 121-126.

15. Trumble T, Fitch RD. Kawasaki disease: A cause of vasculitis in children. J Pediatr Orthop 1986; 6: 92-95.

16. Westphalen MA, McGrath MA, Kelly W, Moore FJ, Ziegler JB. Kawasaki disease with severe peripheral ischemia: treatment with prostaglandin E1 infusion. J Pediatr 1988; 112: 431-433.

17. von Planta M, Fasnacht M, Holm C, Fanconi S, Seger R. Atypical Kawasaki disease with peripheral gangrene and myocardial infarction: therapeutic implications. Eur J Pediatr 1995; 154: 830-834.