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Kawasaki disease complicated by peripheral gangrene

J S Chang1, J S Lin, C T Peng

  • 1Department of Pediatrics, China Medical College Hospital, Taichung, Taiwan, Republic of China.

Pediatric Cardiology
|February 13, 1999
PubMed

Insights

Early recognition and management of peripheral gangrene in Kawasaki disease (KD) can minimize complications. Prompt treatment of limb ischemia in infants with KD led to resolution of most digital issues.

Area of Science:

  • Pediatrics
  • Cardiology
  • Rheumatology

Background:

  • Kawasaki disease (KD) is a critical pediatric illness affecting coronary arteries.
  • Intravenous immunoglobulin (IVIG) is the standard treatment for KD, typically administered early after fever onset.

Observation:

  • A case of an 8.5-month-old infant with KD treated with high-dose IVIG on day 5 of fever.
  • Two days post-IVIG, the infant developed multiple peripheral limb ischemic events.
  • Treatment with heparin and dipyridamole was initiated for the limb ischemia.

Findings:

  • The infant experienced digital ischemia, with a minor amputation of the right middle finger tip.
  • All other instances of peripheral limb ischemia resolved following the anticoagulant and antiplatelet therapy.
  • This case highlights a rare but serious complication of KD and its management.

Implications:

  • Early recognition and intervention for peripheral gangrene in KD are crucial.
  • Timely management can significantly reduce the long-term sequelae of KD-associated ischemia.
  • This approach may preserve limb function and prevent more severe outcomes in affected children.

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