Jaundice at the Onset: A Rare Event in Kawasaki Disease
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SCIENTIFIC LETTER
Jaundice at the Onset: A Rare Event in Kawasaki Disease Sumantra Sarkar 1 & Basundhara Bhattacharyya 2 & Anuradha Agarwal 2 Received: 29 April 2020 / Accepted: 26 October 2020 # Dr. K C Chaudhuri Foundation 2020
To the Editor: Kawasaki disease (KD), a primary vasculitis of medium size arteries, presents as acute febrile illness in children. It predominantly affects skin, mucus membranes, lymph nodes and coronary arteries. Involvement of other systems is uncommon. A rare incidence of hepatic dysfunction and jaundice as the initial presentation in a case of complete KD is reported here. A 1 y 10 mo old girl presented with high grade non-remitting fever, irritability out of proportion to her illness, repeated vomiting and jaundice for 4 d (Fig. 1). She had prominent icterus, dry, cracked lips, reddish tongue, polymorphous rash, erythema of extremities, unilateral cervical lymph node and a tender hepatomegaly. Based on the clinical diagnosis of KD, intravenous immunoglobulin (IVIG) was initiated (2 g/kg over 12 h). Aspirin was withheld considering its hepatotoxic potential. Investigations revealed Hb 8.9 g/dL, TLC 25190/cumm (N 75%), platelets 4.5 L/cumm, CRP 10.7 mg/dL (normal
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