Related Experiment Videos
Kawasaki disease with Reye syndrome: report of one case
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
This case report highlights a rare instance of Reye syndrome developing after Kawasaki disease treatment. High-dose aspirin use in treating Kawasaki disease may pose a risk for Reye syndrome in infants.
Area of Science:
- Pediatrics
- Toxicology
- Infectious Diseases
Background:
- Kawasaki disease is a critical pediatric illness.
- High-dose aspirin is a common treatment for Kawasaki disease.
- Reye syndrome is a rare but serious condition affecting the brain and liver.
Observation:
- A seven-month-old infant diagnosed with Kawasaki disease received high-dose aspirin and intravenous gamma-globulin (IVIG).
- Following initial recovery and a reduced aspirin dosage, the infant developed symptoms suggestive of Reye syndrome, including vomiting and altered consciousness.
- Laboratory results indicated liver dysfunction and metabolic abnormalities consistent with Reye syndrome.
Findings:
- The infant presented with classic Kawasaki disease symptoms and responded initially to IVIG and high-dose aspirin.
- Post-discharge, the patient developed severe symptoms, leading to a diagnosis of Reye syndrome confirmed by liver biopsy.
- Literature review revealed no previously documented correlation between Kawasaki disease and Reye syndrome.
Implications:
- This case suggests a potential, albeit rare, association between high-dose aspirin therapy for Kawasaki disease and the subsequent development of Reye syndrome.
- Clinicians should maintain a high index of suspicion for Reye syndrome in infants treated with high-dose aspirin for Kawasaki disease, especially if neurological or gastrointestinal symptoms arise.
- Further research is warranted to explore the potential link and underlying mechanisms between aspirin use in Kawasaki disease and Reye syndrome.
Abstract:
A seven-month-old girl was admitted to the Pediatrics Department of Mackay Memorial Hospital with the following symptoms and signs: (1) high fever for more than five days; (2) injection of bilateral conjunctiva; (3) bright red lips with strawberry tongue; (4) edematous change of palms and soles, followed by digit desquamation; (5) an ill-defined, erythematous plaque on the scar of the BCG. Kawasaki disease was diagnosed, and high dose aspirin (100 mg/kg/day) and intravenous gamma-globulin (IVIG) (400 mg/kg/day) were given for four days. The patient was afebrile on the second day after IVIG infusion, and was discharged six days after admission. A small single daily dose of aspirin (10 mg/kg/day) was given after the afebrile days. Unfortunately, vomiting and consciousness disturbance were noted one day after discharge. Laboratory data showed elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ammonia. Hypoglycemia and prolonged PT and PTT were also noted. Reye syndrome was suspected, and the patient was admitted to the intensive care unit for further management. A liver biopsy gave findings consistent with Reye syndrome. In spite of intensive treatment, the infant expired on the second day after admission. In a review of the literature, no correlation between these two syndromes was found. This rare case is presented to warn that Reye syndrome may follow Kawasaki disease when aspirin has been prescribed at a high dose.