Department of Pediatrics, Holy Family Hospital, New Delhi, India.
Department of Pediatric Cardiology, Fortis Escorts Heart Institute and Research Centre, New Delhi, India.
BMJ Case Rep. 2021 Mar 24;14(3):e240972. doi: 10.1136/bcr-2020-240972.
SARS-CoV-2 infection has recently been related to a spectrum of hyper-inflammatory states in children. There is a striking similarity between these hyper-inflammatory states and Kawasaki disease (KD). We present an interesting case of KD recurrence in a 10-year-old child, who had previously developed KD at 4 years of age. His symptoms included fever, maculopapular rash and altered sensorium. Investigations showed noticeably elevated inflammatory markers, and an echocardiography revealed dilated coronary arteries. SARS-CoV-2 IgG antibodies were positive. The child responded dramatically to intravenous immunoglobulin and intravenous methylprednisolone. It is possible that SARS-CoV-2 infection triggered the recurrence of KD in this child who might have been genetically predisposed to KD.
SARS-CoV-2 感染与儿童一系列的过度炎症状态有关。这些过度炎症状态与川崎病(KD)之间存在显著的相似性。我们报告了一例有趣的 KD 复发病例,患儿在 4 岁时曾患 KD。他的症状包括发热、斑丘疹和意识改变。检查显示明显升高的炎症标志物,超声心动图显示冠状动脉扩张。SARS-CoV-2 IgG 抗体阳性。患儿对静脉注射免疫球蛋白和甲基强的松龙反应良好。该患儿可能存在 KD 的遗传易感性,SARS-CoV-2 感染可能触发了 KD 的复发。