Article in Japanese

A case presenting with ITP at convalescent phase of Kawasaki disease after the initial intravenous immunoglobulin therapy

Chiaki IKENOUE, Takafumi OKADA, Keita MATSUBARA, Osamu KOMIYAMA

Kawasaki disease (KD) produces a variety of complications, but KD with idiopathic thrombocytopenic purpura (ITP) is rare. We report a three year old boy presenting with ITP after the initial intravenous immunoglobulin (IVIG) for KD.
He was diagnosed as KD on the fifth day of illness, and IVIG was administered. After IVIG, clinical features of KD improved immediately. But on the 13th day of his illness, we identified purpura on this patient's legs and the platelet counts decreased to 0.3×10⁴/μl. We performed bone marrow aspiration and the bone marrow findings demonstrated an increase in immature megakaryocytes, consistent with ITP. So we administered oral prednisolone (PSL). After PSL therapy, the platelet counts increased. There have been few reports of KD with ITP. This case possibly suggests the relations of KD and ITP.

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Department of Pediatrics, National Hospital Organization Tokyo Medical Center

Key words
Received	May 17, 2011
Accepted	September 1, 2011

24 (1)：15─18,2012