Abstract:
BACKGROUND:Kawasaki disease (KD) or mucocutaneous lymph node syndrome is a vasculitis that mostly occurs in young children. Adult-onset KD (AKD) is rare and often misdiagnosed. Here we report a rare case of KD with cholestasis as principal symptom. CASE PRESENTATION:A 43-year-old caucasian man was admitted to our hospital for high fever, lack of appetite related to nausea and vomiting, headache and significant malaise. Physical examination highlighted fever, increasing jaundice, bilateral laterocervical lymph nodes, erythema of the palms, and strikingly red lips and conjunctiva. The clinical course was complicated by arterial hypotension, tachycardia, decreasing haemoglobin, increasing acute phase reactants tests, and multiorgan failure. Due to cardiovascular instability the patient was admitted to the local Intensive Care Unit. Chest X-ray, abdominal ultrasound, chest and abdominal CT and Colangio Magnetic Resonance were normal. Jaundice was investigated and infections, autoimmune diseases or drugs adverse reactions, were excluded. Also coronary artery computed tomography was carried out excluding coronary artery aneurysms. Broad-spectrum antibiotics were not effective. After exclusion other possible conditions, diagnosis of KD was set. He was treated with high doses of corticosteroids and acetylsalicylic acid and clinical conditions as well as laboratory exams improved. CONCLUSIONS:This report dealing with an adult onset of atypical KD may be of benefit to physicians of various specialties, including primary care doctors, hospital internists, intensivists and gastroenterologists due to its peculiarities. It demonstrates that a case of prolonged fever unresponsive to antibiotics and related to cholestatic jaundice, oedema or erythema of the extremity associated with desquamation of feet and hands, and red eyes, may suggest atypical form of KD.
journal_name
BMC Gastroenteroljournal_title
BMC gastroenterologyauthors
Gallerani M,Pala M,Fabbian F,De Giorgi Adoi
10.1186/s12876-020-01495-6subject
Has Abstractpub_date
2020-10-28 00:00:00pages
357issue
1issn
1471-230Xpii
10.1186/s12876-020-01495-6journal_volume
20pub_type
杂志文章abstract:BACKGROUND:The aim of this study was to develop and psychometrically test a short, patient-reported questionnaire to be used in clinical practice for patients with Irritable Bowel Syndrome (IBS). The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) questionnaire was designed to measure the treatment respons...
journal_title:BMC gastroenterology
pub_type: 杂志文章
doi:10.1186/1471-230X-7-16
更新日期:2007-05-03 00:00:00
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
doi:10.1186/1471-230X-12-100
更新日期:2012-08-03 00:00:00
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pub_type: 杂志文章
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更新日期:2012-04-16 00:00:00
abstract:BACKGROUND:Sclerosing encapsulating peritonitis (SEP) is a rare cause of small-bowel obstruction. The optimal treatment for this condition remains controversial. METHODS:In this study, we performed a retrospective analysis of the data of 44 patients who underwent surgery for SEP between December 2001 and 2008 at our h...
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pub_type: 杂志文章
doi:10.1186/1471-230X-14-180
更新日期:2014-11-25 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12876-016-0568-3
更新日期:2017-01-13 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-01-15 00:00:00
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更新日期:2011-11-02 00:00:00
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pub_type: 杂志文章,评审
doi:10.1186/s12876-015-0313-3
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pub_type: 杂志文章
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