Atypically Protracted Course of Liver Involvement in Kawasaki Disease. Case Report and Literature Review
| Autor: | Maria Chiara Rocco, Anna Giulia Elena De Anseris, Milena Lettieri, R. Colantuono, Pietro Vajro, Nicola Biffaro, P. Paglia, Maria Siano, Lucia Nazzaro |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
literature review Pediatrics Liver tests Gastroenterology RJ1-570 03 medical and health sciences Protracted course 0302 clinical medicine 030225 pediatrics Internal medicine case report Medicine In patient 030212 general & internal medicine Rapid response Kawasaki disease business.industry medicine.disease persistent hypertransaminasemia Intravenous Immunoglobulins Liver dysfunction Differential diagnosis business |
| Zdroj: | Pediatric Reports Pediatric Reports, Vol 13, Iss 44, Pp 357-362 (2021) |
| ISSN: | 2036-7503 |
| Popis: | 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: | OpenAIRE |
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