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Malekzadeh I, Ziaee V, Sadrosadat T, et al. Kawasaki Disease and Peripheral Gangrene in Infancy. Iran J Pediatr. 2015;25(6):e3309doi: 10.5812/ijp.3309.
Malekzadeh, I., Ziaee, V., Sadrosadat, T., Moardinejad, M. H., & Sayadpour-Zanjani, K. (2015). Kawasaki Disease and Peripheral Gangrene in Infancy. Iranian journal of pediatrics, 25(6), e3309. https://doi.org/10.5812/ijp.3309
Malekzadeh, Iran, et al. "Kawasaki Disease and Peripheral Gangrene in Infancy." Iranian journal of pediatrics vol. 25,6 (2015): e3309. doi: https://doi.org/10.5812/ijp.3309
Malekzadeh I, Ziaee V, Sadrosadat T, Moardinejad MH, Sayadpour-Zanjani K. Kawasaki Disease and Peripheral Gangrene in Infancy. Iran J Pediatr. 2015 Dec;25(6):e3309. doi: 10.5812/ijp.3309. Epub 2015 Dec 23. PMID: 26635941; PMCID: PMC4662841.
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Iran J Pediatr. 2015 Dec;25(6):e3309. doi: 10.5812/ijp.3309. Epub 2015 Dec 23.

Kawasaki Disease and Peripheral Gangrene in Infancy.

Iranian journal of pediatrics

Iran Malekzadeh, Vahid Ziaee, Taravat Sadrosadat, Mohammad-Hassan Moardinejad, Keyhan Sayadpour-Zanjani

Affiliations

  1. Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, IR Iran.
  2. Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran ; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IR Iran.
  3. Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, IR Iran ; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IR Iran.
  4. Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IR Iran.

PMID: 26635941 PMCID: PMC4662841 DOI: 10.5812/ijp.3309

Abstract

INTRODUCTION: Early diagnosis and treatment of Kawasaki disease as the most common cause of acquired heart disease in childhood, may significantly improve the prognosis. Diagnosing infantile Kawasaki (younger than a year) is difficult because of obscure symptoms; at the same time they are at the higher risk of coronary abnormalities.

CASE PRESENTATION: We report three infants with prolonged (more than 5 days) fever and peripheral gangrene without any other clinical manifestations of Kawasaki disease. Kawasaki was diagnosed due to dilation of coronary artery and other aortic branches, thrombocytosis, and rising of ESR and CRP. All patients were treated with high dose aspirin, IVIG and pulse therapy with methylprednisolone. Additionally, cytotoxic drugs or infliximab were used for two of them because of severe aneurysms in the aortic branches. All 3 patients received aspirin with anti-platelet aggregation dose and 2 patients heparin as an anti-coagulant agent for longtime. After adequate treatment, peripheral gangrene, arterial dilations and aneurysms improved, but during 12 months follow-up coronary aneurysms did not improve completely.

CONCLUSIONS: Peripheral gangrene must be regarded as an important sign of infantile Kawasaki disease early treatment of which can prevent severe permanent coronary involvements and sequels.

Keywords: Gangrene; Infantile Polyarthritis; Kawasaki Disease; Vasculitis

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