Related Experiment Video

Updated: May 25, 2026

Lipopolysaccharide Infusion as a Porcine Endotoxemic Shock Model
05:52

Lipopolysaccharide Infusion as a Porcine Endotoxemic Shock Model

Published on: December 8, 2023

Kawasaki disease: an unexpected etiology of shock and multiple organ dysfunction syndrome

Pauline Gatterre1, Mehdi Oualha, Laurent Dupic

  • 1Service de Réanimation Pédiatrique, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Descartes, 149, Rue de Sèvres, 75743, Paris Cedex 15, France.

Intensive Care Medicine
|January 26, 2012
PubMed

Insights

Severe Kawasaki disease (KD) with shock can cause multiple organ dysfunction syndrome (MODS). Prompt diagnosis and treatment of these severe KD cases led to complete recovery in all pediatric patients studied.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Rheumatology

Background:

  • Severe forms of Kawasaki disease (KD) are increasingly associated with shock and coronary artery abnormalities (CAA).
  • Limited data exists on non-cardiovascular organ involvement and outcomes in severe KD presenting with shock.

Purpose of the Study:

  • To analyze organ involvement beyond cardiovascular aspects in severe KD patients admitted to the PICU.
  • To assess the outcomes of severe KD with shock compared to common forms.

Main Methods:

  • Retrospective study of 11 patients diagnosed with KD and admitted to a pediatric intensive care unit (PICU) between 2001 and 2009.
  • Analysis of clinical data, including organ involvement, diagnostic delays, treatment duration, and patient outcomes.

Main Results:

  • Seven patients (63%) developed CAA, with complete regression observed.
  • Non-specific encephalopathy and acute kidney injury were common findings.
  • Eight patients experienced Multiple Organ Dysfunction Syndrome (MODS), yet all 11 children survived without sequelae despite predicted high mortality.

Conclusions:

  • Moderate shock is a primary reason for PICU admission in KD patients.
  • Severe KD with shock can present with significant MODS, highlighting the need for early recognition.
  • Timely diagnosis and treatment are crucial for favorable outcomes in these severe KD cases.
Abstract

Related Concept Videos

Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
Blood Pressure Imbalances and Circulatory Shock01:24

Blood Pressure Imbalances and Circulatory Shock

Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...