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Lack of efficacy in Kawasaki disease: case report A 22-month-old girl exhibited lack of efficacy with immune-globulin during treatment for Kawasaki disease (KD). The girl was admitted to hospital in the Portugal due to persistent fever for 8 days associated with generalised maculo-papular exanthema and bilateral cervical adenopathies affecting palms. Laboratory tests showed leucocytosis, neutrophilia and elevated CRP. She was suspected to have occult bacteremia and was treated with amoxicillin without improvement. Subsequently, she fulfilled three criteria of KD and further laboratory tests supported the diagnosis of KD. An echocardiogram revealed a dilated anterior descendent coronary artery. She received a single dose of IV immune-globulin [immunoglobulin] at 2 g/kg along with aspirin at anti-inflammatory dosage resulting in clinical improvement. However, in two days, her fever reappeared. She repeated IV immune-globulin administration without any clinical improvement. The girl started receiving treatment with methylprednisolone pulses on hospitalisation day 10 for three days with a clinical improvement. She was discharged on aspirin at antiplatelet dosage. Lanca A, et al. Fever of unknown origin in young children: Think Kawasaki. European Journal of Pediatrics 178: 1711 abstr. 518, No. 11, Nov 2019. Available from: URL: 803503338 http://doi.org/10.1007/s00431-019-03466-w [abstract]

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Reactions 26 Sep 2020 No. 1823