Script Macromedia Flash
 

Pesquisa

Topo 1
Topo 2

Kawasaki Disease

Mary Beth F. Son, Jane W. Newburger. Pediatrics in Review Feb 2018, 39 (2) 78-90; DOI: 10.1542/pir.2016-018

Case Study

A 3-year-old previously healthy Hispanic girl is brought to her pediatrician’s office by her mother with a history of 6 days of fever. The fever has been present daily and unremitting despite administration of antipyretic medications. She has been irritable, with decreased appetite. Her mother noticed an erythematous nonpruritic rash covering her torso 1 day after fever onset. She has developed red eyes in the past 2 days. She has no siblings and attends child care.

On examination she is febrile to 102°F (38.9°C) and tachycardic at 140 beats/min. Her blood pressure while crying is 110/60 mm Hg. Her weight is 32 lb (14.5 kg). She has conjunctival injection with limbal sparing and without exudate. Her lips appear erythematous and cracked, and her oropharynx is diffusely erythematous without exudates. She does not have substantial cervical chain lymphadenopathy. A polymorphous maculopapular rash covers her torso and extremities. The dorsum of her hands and feet appear swollen.

On laboratory examination she has a total white blood cell count of 15.6/μL (×109/L), her hemoglobin level is 9.8 g/dL (98 g/L), and her platelet count is 669,000×103/μL (×109/L). The differential count of the white blood cells is 81% neutrophils and 14% lymphocytes. She has mild elevation of her transaminase values, with an alanine aminotransferase level of 68 U/L (1.14 μkat/L) and a normal aspartate aminotransferase level. Her C-reactive protein (CRP) level is 98 mg/L (933 nmol/L), and her erythrocyte sedimentation rate is 65 mm/hour. There are 25 white blood cells per high-power field on urinalysis.

 

Artigo disponível em: http://pedsinreview.aappublications.org/content/39/2/78

Voltar