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Article in Japanese

A case of severe Kawasaki disease complicated by encephalopathy

Hiromi FUJII1), Shota ONO1), Shunsaku KAJI1)

This paper reports the case of 4-year-old girl Kawasaki disease complicated by acute encephalopathy. She presented with red eyes, dry red lips, red tongue, neck lymph node swelling, and rash on day 4 after admission. Therefore, she received a diagnosis of Kawasaki disease and was treated withγ-globulin(2 g/kg) and prednisolone(2 mg/kg/day), due to a high Kobayashi risk score of 10. The red eyes and lips remained at five days post-admission, despite a diminishing fever, and she developed abnormal behavior simultaneously. No abnormality was found on normal brain magnetic resonance imaging(MRI) or cerebrospinal fluid examination; but acute encephalopathy was diagnosed by electroencephalography. As her condition recovered day-by-day, additional treatment for specifically encephalopathy was not provided. However, her fever returned several times. Finally, even though the patient was treated withγ -globulin(total 6 g/kg), prednisolone, and cyclosporine A(from day 8), no coronary aneurysm occurred.

1) Department of Pediatrics, Tsuyama Chuo Hospital

Key words Kawasaki disease, encephalopathy, γ-globulin, prednisolone, cyclosporine A
Received January 13, 2017
Accepted December 22, 2017

29 (4):362─367,2018