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Published on: April 21, 2017
Ischemic stroke in Kawasaki disease
Wasana Prangwatanagul1, Alisa Limsuwan1
1Division of Pediatric Cardiology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Pediatric stroke is rare, but Kawasaki disease (KD) can cause neurological symptoms like stroke in children. This case highlights stroke as an uncommon manifestation of KD, emphasizing the need for awareness in pediatric neurology.
Area of Science:
- Pediatric Neurology
- Pediatric Cardiology
- Rheumatology
Background:
- Kawasaki disease (KD) is an acquired vasculitis with increasing diagnosis rates.
- Neurological symptoms, including stroke, are uncommon but reported presentations of KD.
- Cerebral vasculitis is a rare cause of stroke in young children.
Observation:
- A 15-month-old boy presented with stroke on day five of a febrile illness.
- Initial diagnosis was encephalomeningitis, but subsequent evaluation revealed right middle cerebral artery branch stenosis and coronary artery aneurysms.
- The patient met the full clinical criteria for Kawasaki disease retrospectively.
Findings:
- The patient experienced left hemiplegia secondary to stroke.
- Cerebral artery stenosis and coronary artery aneurysms were identified.
- Kawasaki disease was confirmed as the underlying cause of vasculitis.
Implications:
- Stroke can be an uncommon clinical manifestation of Kawasaki disease in pediatric patients.
- Early recognition of KD is crucial for managing neurological complications like stroke.
- This case underscores the importance of considering vasculitis in pediatric stroke evaluations.
Abstract:
Pediatric stroke is considered to be rare. Stroke resulting from cerebral vasculitis is also uncommon in young children. With the increasing prevalence of Kawasaki disease (KD) diagnosis, this acquired vasculitis has been reported with various clinical presentations including neurological symptoms. Herein we describe the case of a KD patient presenting with stroke. A 15-month-old boy was referred due to stroke that occurred on the fifth day of febrile illness. He was initially admitted to another hospital due to fever and diarrhea. He was discharged and re-admitted 2 days afterward due to left hemiplegia. During the 10 days of the second hospitalization, he had a presumptive diagnosis of encephalomeningitis. Upon referral to the present hospital, he was found to have right middle cerebral artery branch stenosis and fusiform aneurysms of the coronary arteries. Retrospectively, the patient had the full clinical criteria for KD diagnosis. Therefore, stroke could be considered as one of the uncommon clinical manifestations of KD.
