Yi Cong, She Xiang, Chen Jia
Department of Pediatrics, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Front Pediatr. 2023 Apr 21;11:1152242. doi: 10.3389/fped.2023.1152242. eCollection 2023.
Kawasaki disease (KD) is an acute systemic vasculitis that can involve multiple organs. Few reports have been published about KD patients presenting with multiple complications such as acute abdomen, KD shock syndrome (KDSS), and macrophage activation syndrome (MAS).
We present the cases of two males (9 and 12 years old) diagnosed with KD accompanied by rare manifestations. Case 1 is a 9-year-old male treated for acute appendicitis, KDSS, and MAS. Case 2 is a 12-year-old male who presented with KDSS, MAS, and an ileal perforation. They were treated with intravenous immunoglobulin, aspirin, high-dose corticosteroids, vasoactive drugs, and symptomatic treatment, with good outcomes.
Clinicians should be aware of the possibility of KD in the presence of fever and unusual manifestations, such as severe inflammatory indicators and acute abdomen that is nonresponsive to antibiotic therapy. Meanwhile, KD-related unusual complications should be recognized, such as KDSS and MAS.
川崎病（KD）是一种可累及多个器官的急性全身性血管炎。关于出现诸如急腹症、川崎病休克综合征（KDSS）和巨噬细胞活化综合征（MAS）等多种并发症的KD患者的报道较少。
我们报告了两名男性（9岁和12岁）诊断为KD并伴有罕见表现的病例。病例1是一名9岁男性，因急性阑尾炎、KDSS和MAS接受治疗。病例2是一名12岁男性，表现为KDSS、MAS和回肠穿孔。他们接受了静脉注射免疫球蛋白、阿司匹林、大剂量皮质类固醇、血管活性药物及对症治疗，效果良好。
临床医生应意识到在出现发热和异常表现（如严重炎症指标和对抗生素治疗无反应的急腹症）时存在KD的可能性。同时，应认识到与KD相关的异常并发症，如KDSS和MAS。
