Severe Kawasaki Disease and Thrombocytopenia: A Case Report

Area of Science:

• Pediatrics
• Rheumatology
• Immunology

Background:

• Kawasaki disease (KD) is a medium vessel vasculitis primarily impacting coronary arteries.
• Diagnosis relies heavily on clinical criteria, with thrombocytosis being a common laboratory finding.
• The underlying mechanism of KD remains largely unknown.

Observation:

• A 2-year-old girl presented with a week-long fever and rash.
• Clinical signs included a generalized rash, conjunctivitis, cheilitis, and strawberry tongue.
• Initial laboratory tests revealed an inflammatory syndrome and significant thrombocytopenia (91,000/mm³).

Findings:

• This case presents an atypical biological profile for Kawasaki disease, characterized by thrombocytopenia instead of the usual thrombocytosis.
• The patient received standard treatment with intravenous immunoglobulins and acetylsalicylic acid.
• The treatment resulted in a favorable clinical evolution and complete resolution of thrombocytopenia.

Implications:

• This case underscores the importance of considering Kawasaki disease even with atypical laboratory findings like thrombocytopenia.
• Early diagnosis and treatment are crucial for preventing coronary artery complications.
• Further research may elucidate the varied pathophysiological mechanisms underlying Kawasaki disease presentations.