Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review.

Autor: Paglia P; Chair of Pediatrics and Residency Program of Pediatrics, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081 Baronissi, Italy., Nazzaro L; Pediatrics Units of San Giovanni di Dio e Ruggi d'Aragona University Hospital, 84131 Salerno, Italy., De Anseris AGE; Pediatrics Units of San Giovanni di Dio e Ruggi d'Aragona University Hospital, 84131 Salerno, Italy., Lettieri M; Chair of Pediatrics and Residency Program of Pediatrics, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081 Baronissi, Italy.; Department of Translational Medical Sciences, Section of Pediatrics, 'Federico II' University, 80131 Naples, Italy., Colantuono R; Chair of Pediatrics and Residency Program of Pediatrics, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081 Baronissi, Italy., Rocco MC; Chair of Pediatrics and Residency Program of Pediatrics, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081 Baronissi, Italy., Siano MA; Chair of Pediatrics and Residency Program of Pediatrics, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081 Baronissi, Italy., Biffaro N; Chair of Pediatrics and Residency Program of Pediatrics, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081 Baronissi, Italy., Vajro P; Chair of Pediatrics and Residency Program of Pediatrics, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, 84081 Baronissi, Italy.; Pediatrics Units of San Giovanni di Dio e Ruggi d'Aragona University Hospital, 84131 Salerno, Italy.
Jazyk: angličtina
Zdroj: Pediatric reports [Pediatr Rep] 2021 Jul 01; Vol. 13 (3), pp. 357-362. Date of Electronic Publication: 2021 Jul 01.
DOI: 10.3390/pediatric13030044
Abstrakt: Hypertransaminasemia in patients with Kawasaki disease (KD) is reported to be transient. Here, we describe a child with an atypically protracted course of liver tests abnormalities and review the inherent literature. The patient was hospitalized at age 7-months for isolated hypertransaminasemia detected during a classical KD diagnosed 3 months before, and persistent since then. KD clinical evolution had been favorable, with rapid response to acetylsalicylic acid and intravenous immunoglobulins. Liver enzymes however remained persistently elevated with a fluctuating pattern (ALT > AST levels; peak of AST 186 IU/L and ALT 240 IU/L). During follow-up, the main causes of liver dysfunction had to be excluded through appropriate and extensive laboratory investigations. Transaminases values become steadily normal only 7 months after the acute presentation of KD. Conclusions: Our report shows that an atypically protracted courses of KD-related hypertransaminasemia above the previously reported temporal limits should be taken into account during the stepwise diagnostic approach to the patient's liver dysfunction. Insidious acetylsalycilic acid-hepatotoxicity warrants consideration in the differential diagnosis.
Databáze: MEDLINE
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