Pulse methylprednisolone therapy for impending cardiac tamponade in immunoglobulin-resistant Kawasaki disease

Intensive Care Med. 1999 Oct;25(10):1137-9. doi: 10.1007/s001340051025.

Abstract

We describe a boy with Kawasaki disease (KD) whose clinical course was marked by a rapid improvement upon treatment with intravenous immunoglobulin (IVIG) and oral aspirin, which - within 14 days - was followed by the development of a large pericardial effusion with symptoms of impending cardiac tamponade as part of a polyserositis syndrome (pleural effusions, ascites). Upon treatment with pulsed methylprednisolone, the pericardial and pleural effusions and ascites rapidly disappeared within 48 h. This is the first case reported with a polyserositis syndrome and impending cardiac tamponade during KD.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Anti-Inflammatory Agents / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Aspirin / therapeutic use
  • Cardiac Tamponade / diagnosis
  • Cardiac Tamponade / etiology*
  • Cardiac Tamponade / prevention & control*
  • Child
  • Diagnosis, Differential
  • Disease Progression
  • Drug Administration Schedule
  • Echocardiography
  • Electrocardiography
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Male
  • Methylprednisolone / therapeutic use*
  • Mucocutaneous Lymph Node Syndrome / complications*
  • Mucocutaneous Lymph Node Syndrome / drug therapy*
  • Mucocutaneous Lymph Node Syndrome / immunology
  • Pericardial Effusion / diagnosis
  • Pericardial Effusion / etiology*
  • Pericardial Effusion / prevention & control*
  • Pleural Effusion / diagnosis
  • Pleural Effusion / etiology*
  • Pleural Effusion / prevention & control*
  • Time Factors

Substances

  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunoglobulins, Intravenous
  • Aspirin
  • Methylprednisolone