An infant with Kawasaki disease having gastrointestinal bleeding due to multiple gastric ulcers

Area of Science:

• Pediatric Rheumatology
• Gastroenterology
• Systemic Vasculitis

Background:

• Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
• Gastrointestinal (GI) symptoms are common in KD, but severe GI bleeding is a rare complication.
• Standard KD treatment includes intravenous immunoglobulin (IVIG), aspirin, and corticosteroids.

Purpose of the Study:

• To report a rare case of severe GI bleeding in a patient with incomplete Kawasaki disease.
• To investigate the potential causes of GI bleeding in KD patients, including medication side effects.
• To emphasize the importance of vigilant GI monitoring in KD management.

Main Methods:

• Case report of an 11-month-old female diagnosed with incomplete Kawasaki disease.
• Review of clinical presentation, diagnostic workup, and treatment course.
• Analysis of contributing factors to severe gastrointestinal bleeding, including medications.

Main Results:

• The patient developed multiple gastric ulcers and severe GI bleeding requiring blood transfusion.
• Bleeding occurred despite prophylactic H2-receptor antagonist therapy.
• Potential contributing factors identified include KD itself and the combined effects of corticosteroids and NSAIDs.

Conclusions:

• Gastrointestinal bleeding can be a direct and severe complication of Kawasaki disease.
• Corticosteroids and NSAIDs may increase the risk of GI bleeding in KD patients.
• Vigilant monitoring for GI complications and further research into preventative strategies are crucial for managing KD.