Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 9:11:1281909.
doi: 10.3389/fped.2023.1281909. eCollection 2023.

Jaundice-predominant manifestation of Kawasaki disease in children

Ya-Ning Huang  1   2 , Chien-Yu Lin  1   2   3 , Hsin Chi  3   4 , Nan-Chang Chiu  3   4 , Daniel Tsung-Ning Huang  3   4 , Lung Chang  3   4   5 , Yen-Hsin Kung  4   5 , Ching-Ying Huang  3   4
Affiliations

Jaundice-predominant manifestation of Kawasaki disease in children

Ya-Ning Huang et al. Front Pediatr. .

Abstract

Background: A jaundice-predominant presentation of Kawasaki disease (KD) is atypical.

Methods: A total of 12 children with KD with a predominant manifestation of jaundice at MacKay Children's Hospital were reviewed, along with 42 cases reported in the literature since 1990.

Results: The median age of the 12 patients was 1.85 years (range: 3 months-4 years), and 66.6% were male. All of the patients had elevated liver function at presentation, 50% had hydrops of the gallbladder, and almost 60% had gastrointestinal symptoms and signs. Complete KD was evident in 11 of the 12 patients (91.7%), and two patients (16.7%) had recurrent episodes. All of the patients received intravenous immunoglobulin (IVIG); however, one-third were refractory to treatment. Corticosteroids were used in five (41.7%) of the patients. Three (25%) of the patients had shock, and seven (58.3%) had coronary artery abnormalities, of whom one (8.3%) had persistent coronary artery aneurysm and the others recovered. A review of the 42 cases in the literature showed that the children with a jaundice-predominant presentation of KD had high rates of IVIG-refractory disease (25%), coronary artery abnormalities (25%), shock (13.2%), and corticosteroid treatment (24.2%).

Conclusions: Children with KD presenting with a jaundice-predominant manifestation are at a higher risk of IVIG-refractory disease, coronary artery abnormalities, and more recurrent episodes. Physicians should be aware of the risk of shock in this population.

Keywords: IVIG-refractory disease; Kawasaki disease; children; hyperbilirubinemia; jaundice.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Dimitriades VR, Brown AG, Gedalia A. Kawasaki disease: pathophysiology, clinical manifestations, and management. Curr Rheumatol Rep. (2014) 16(6):423. 10.1007/s11926-014-0423-x - DOI - PubMed
    1. Li T, Feng J, Li N, Liu T. Correct identification of incomplete Kawasaki disease. J Int Med Res. (2021) 49(3):3000605211001712. 10.1177/03000605211001712 - DOI - PMC - PubMed
    1. Burns JC, Mason WH, Glode MP, Shulman ST, Melish ME, Meissner C, et al. Clinical and epidemiologic characteristics of patients referred for evaluation of possible Kawasaki disease. United States multicenter Kawasaki disease study group. J Pediatr. (1991) 118(5):680–6. 10.1016/S0022-3476(05)80026-5 - DOI - PubMed
    1. Grewal A, Singh S, Suri D, Lal S, Manojkumar R, Thapa BR. Kawasaki disease masquerading as jaundice. Indian J Pediatr. (2013) 80(3):261–2. 10.1007/s12098-012-0736-6 - DOI - PubMed
    1. Falcini F, Resti M, Azzari C, Simonini G, Veltroni M, Lionetti P. Acute febrile cholestasis as an inaugural manifestation of Kawasaki’s disease. Clin Exp Rheumatol. (2000) 18(6):779–80. PMID: - PubMed

LinkOut - more resources