Myositis in Kawasaki disease

Area of Science:

• Neurology
• Pediatrics
• Rheumatology

Background:

• Kawasaki disease (KD) is an acute febrile vasculitis affecting medium-sized arteries, primarily in children.
• Neurologic complications, including myositis, can occur in KD, though often remain undiagnosed.

Observation:

• This report details an unusual case of KD complicated by severe myositis and subsequent respiratory failure due to muscle weakness.
• Comparison with existing literature highlights that myositis in KD typically manifests 1-3 weeks after illness onset.

Findings:

• While often mild and unnoticed, KD-associated myositis can lead to significant muscle weakness and respiratory compromise.
• Elevated creatine kinase (CK) levels may serve as a valuable biomarker for predicting myopathy severity and the need for respiratory monitoring.

Implications:

• Physicians should consider myositis in the differential diagnosis of neurologic complications in Kawasaki disease.
• Close respiratory monitoring is essential in patients with KD-induced myositis, particularly those with elevated CK levels.
• Supportive therapy is the mainstay of treatment, with complete recovery anticipated.