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Circ J. 2006 Feb;70(2):202-5.

Four cases of Kawasaki syndrome complicated with myocarditis.

Author information

1
Division of Pediatrics, Graduate School of Medical and Dental sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. yosshii@po2.synapse.ne.jp

Abstract

BACKGROUND:

Myocarditis frequently occurs in the acute phase of Kawasaki syndrome (KS), and a few severe cases have been reported. Four cases of myocarditis in KS required additional catecholamine treatment because of severe left ventricular dysfunction (LVD).

CASE REPORTS:

Three cases were relatively older children and 2 cases were complicated with encephalopathy. All 4 developed coronary artery abnormalities during convalescence. There was 1 case of LVD because of prolonged severe inflammation prior to administration of intravenous immunoglobulin (IVIG). The remaining 3 patients had normal values for ejection fraction before the administration of IVIG but decreased values (42-51%) and increased C-reactive protein levels after IVIG administration. These cases demonstrate an association between myocarditis in KS and severe or worsened inflammation.

CONCLUSIONS:

Even with prior normal echocardiography, careful observation of cardiac function may be necessary for patients with KS, especially older children, when inflammation deteriorates after administration of IVIG.

PMID:
16434816
[Indexed for MEDLINE]
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