To describe a case of Kawasaki disease with intestinal involvement and to analyze other published reports to define clinical characteristics, diagnostic issues, and therapeutic approaches of gastrointestinal involvement in Kawasaki disease

Cascio, Antonio

Ciccia, Francesco

Colomba, Claudia

Corsello, Giovanni

Di Carlo, Paola

La Placa, Simona

MEDAGLIA, Alice Annalisa

Romanin, Benedetta

Saporito, Laura

Serra, Nicola

Archivio istituzionale della ricerca - Università di Palermo

Intestinal Involvement in Kawasaki Disease

Objectives: To describe a case of Kawasaki disease with intestinal involvement and to analyze other published reports to define clinical characteristics, diagnostic issues, and therapeutic approaches of gastrointestinal involvement in Kawasaki disease. Study design: A computerized search without language restriction was conducted using PubMed and SCOPUS. An article was considered eligible for inclusion in the systematic review if it reported data on patient(s) with intestinal involvement in Kawasaki disease. Our case was also included in the analysis. Results: Thirty-three articles reporting 48 cases of Kawasaki disease with intestinal involvement were considered. Fever, abdominal pain, and vomiting were the most frequent symptoms observed and typical Kawasaki disease signs and symptoms appeared after intestinal complaints in all cases. Plain radiographs, ultrasonography, and computed tomography showed pseudo-obstruction as the most frequent sign of gastrointestinal involvement; 25 patients underwent surgery. Cardiac involvement was documented in 21 cases. All but three patients received medical treatment with immunoglobulin intravenous or aspirin. The outcome was good in 28 patients; 7 patients showed persistence of coronary artery abnormalities; 1 patient developed cyanosis, and later, left hand and forefoot gangrene; 3 patients died. Conclusions: The diagnosis and treatment of Kawasaki disease might be delayed if intestinal symptoms appear before the characteristic clinical features of Kawasaki disease, thus, increasing the risk of cardiac complications. Furthermore, patients may undergo unnecessary invasive procedures. Pediatricians and pediatric surgeons, therefore, should consider Kawasaki disease among diagnoses in children with fever, abdominal symptoms, and radiologic findings of pseudo-obstruction

Colomba C.

La Placa S.

Saporito L.

Corsello G.

Ciccia F.

Medaglia A.

Romanin B.

Serra N.

Di Carlo P.

Cascio A.

Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli"

https://iris.unipa.it/bitstream/10447/350574/1/kawasaki%20ubblicazione.pdf

Intestinal Involvement in Kawasaki Disease

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Archivio istituzionale della ricerca - Università di Palermo

Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli"