Symptomatic myocarditis in Kawasaki disease

Area of Science:

• Pediatric Cardiology
• Rheumatology
• Immunology

Background:

• Kawasaki disease (KD) is an acute febrile illness causing vasculitis, primarily in children.
• Coronary artery involvement is common, but symptomatic heart failure is rare.

Observation:

• A 9-year-old boy presented with severe heart failure during the acute phase of KD.
• Initial treatment with intravenous immunoglobulin yielded limited clinical improvement.

Findings:

• The patient received 5 daily pulses of intravenous methylprednisolone and oral prednisolone.
• Prompt clinical recovery and sustained well-being were observed following steroid therapy.

Implications:

• Methylprednisolone can be a valuable rescue therapy for acute Kawasaki disease with symptomatic congestive heart failure.
• This case highlights the potential benefit of early steroid intervention in severe KD cardiac manifestations.