Bilateral renal artery stenosis in Kawasaki disease: a report of two cases

Area of Science:

• Pediatric Nephrology
• Cardiovascular Pediatrics
• Pediatric Rheumatology

Background:

• Kawasaki Disease (KD) is a critical illness in children, primarily affecting infants and young children.
• While KD's acute phase is well-documented, its sub-acute sequelae require further investigation.
• Secondary hypertension is a recognized but less common complication in pediatric populations.

Observation:

• Two pediatric cases, a boy and a girl, presented with severe renal hypertension.
• The hypertension emerged during the sub-acute phase, weeks after the initial KD diagnosis.
• No other clear cause for secondary hypertension was identified in these cases.

Findings:

• The cases demonstrate a strong association between Kawasaki Disease and the subsequent development of severe renal hypertension.
• This suggests a potential pathophysiological link between KD and renal vascular complications.
• Early recognition and management of hypertension are crucial in KD patients.

Implications:

• Paediatricians should maintain a high index of suspicion for secondary hypertension in infants with a history of KD.
• Prompt blood pressure monitoring and antihypertensive management are vital for preventing severe outcomes.
• Further research is warranted to elucidate the mechanisms linking KD to renal hypertension and to establish optimal screening protocols.