Kawasaki disease is an acute and time-limited systemic vasculitis primarily affecting young children.
We describe an 18-month-old girl with Kawasaki disease who developed cerebral infarction following complete occlusion of her right internal carotid artery.
The occlusion occurred 10 days after the onset of fever, while she was on high-dose aspirin, and the day after she received intravenous immunoglobulin treatment. We present the first literature review on this very rare complication.
Stroke is a rare neurological complication in Kawasaki disease. Optimal treatment should be begun as soon as possible after diagnosis. Intravenous immunoglobulins seem to reduce the cerebrovascular complications, but evaluation of hydration status is strongly recommended before performing such treatment.
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- Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association.Pediatrics. 2004; 114: 1708-1733
- Pathogenesis and management of Kawasaki disease.Expert Rev Anti Infect Ther. 2010; 8: 197-203
- Complications of Kawasaki disease.Curr Paediatr. 2005; 15: 62-68
- Neurological complications in Kawasaki disease.Brain Dev. 1983; 5: 371-374
- Mucocutaneous lymph node syndrome with various arterial lesions.Helv Paediatr Acta. 1978; 33: 127-133
- [Kawasaki disease complicated by thrombosis of the internal carotid artery].Ann Dermatol Venereol. 1979; 106: 901-905
- [Acute hemiplegia complicating Kawasaki disease].Rev Neurol (Paris). 1984; 140: 507-509
- Acute hemiplegia in Kawasaki disease and infantile polyarteritis nodosa.Dev Med Child Neurol. 1984; 26: 814-818
- Cerebral infarction and regression of widespread aneurysms in Kawasaki's disease: case report.Pediatr Radiol. 1984; 14: 1-5
- Kawasaki syndrome: cerebral and cardiovascular complications.J Clin Ultrasound. 1987; 15: 483-485
- Kawasaki disease complicated by cerebral infarction.Cardiol Young. 2003; 13: 103-105
- Cerebral infarction after high-dose intravenous immunoglobulin therapy for Kawasaki disease.J Pediatr. 2006; 148: 399-400
- Asymptomatic cerebral infarction in Kawasaki disease.Pediatr Neurol. 1992; 8: 235-236
- Magnetic resonance studies of brain lesions in patients with Kawasaki disease.Brain Dev. 2006; 28: 30-33
- Ruptured pediatric posterior cerebral artery aneurysm 9 years after the onset of Kawasaki disease: a case report.Childs Nerv Syst. 2007; 23: 701-706
- A ruptured middle cerebral artery aneurysm in a 13-month-old boy with Kawasaki disease.J Neurosurg Pediatr. 2010; 6: 150-153
- Cerebral vasculitis in severe Kawasaki disease: early detection by magnetic resonance imaging and good outcome after intensive treatment.Dev Med Child Neurol. 2012; 54: 1160-1163
- Intravenous immunoglobulin-associated arterial and venous thrombosis; report of a series and review of the literature.Br J Dermatol. 2006; 155: 714-721
- Venous and arterial thrombosis following administration of intravenous immunoglobulins.Blood Coagul Fibrinolysis. 2005; 16: 313-318
- The clinical features of 16 cases of stroke associated with administration of IVIg.Neurology. 2003; 60: 1822-1824
- Effect of high-dose intravenous immunoglobulin therapy on blood rheology.Lancet. 1992; 339: 662-664
- Early treatment with intravenous immunoglobulin in patients with Kawasaki disease.J Pediatr. 2002; 140: 450-455
- Oxidative stress in children late after Kawasaki disease: relationship with carotid atherosclerosis and stiffness.BMC Pediatr. 2008; 8: 20
- Characteristics of earlier atherosclerotic involvement in adolescent patients with Kawasaki disease and coronary artery lesions: significance of gray scale median on B-mode ultrasound.Atherosclerosis. 2009; 222: 106-109
- Age-related acceleration of endothelial dysfunction and subclinical atherosclerosis in subjects with coronary artery lesions after Kawasaki disease.Pediatr Cardiol. 2009; 30: 262-268
Published online: October 07, 2013
Accepted: August 11, 2013
Received: May 8, 2013
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.