Abstract
Intravenous immunoglobulin (IVIG) is currently the standard treatment for Kawasaki disease (KD). Although IVIG therapy is generally well tolerated, several minor adverse reactions have been reported. We report a patient with KD treated with IVIG, who developed a cutaneous reaction in the convalescent phase (approximately 10 days after therapy). We identified seven additional KD cases with a similar presentation, accounting for 9.3 % of KD patients at our hospital. We performed a literature review and found that a maculopapular rash could be observed approximately 10 days after IVIG treatment, in patients with and those without KD. Conclusion: Maculopapular rash can occur in nearly 10 % of IVIG-treated children with KD in our cohort, approximately 10 days after treatment. A delayed-onset adverse event of IVIG could be a causative etiology of this unrecognized eruption.
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Abbreviations
- KD:
-
Kawasaki disease
- IVIG:
-
Intravenous immunoglobulin
References
Aubart CF, Barete S, Amoura Z, Frances C, Lyon-Caen O, Lebrun-Vignes B (2009) Intravenous immunoglobulins-induced eczematous eruption: a long-term follow-up study. Eur J Intern Med 20:70–73
Caress JB, Kennedy BL, Eickman KD (2010) Safety of intravenous immunoglobulin treatment. Expert Opin Drug Saf 9:971–979
Ichikawa K, Tadaki H, Hokozaki T, Nishiyama Y, Fujioka K, Tokuhiro E (2004) Five cases of Kawasaki disease with atypical fever and rash post immunoglobulin therapy. Journal Kanagawa Med Assoc 31:209 (abstract)
Katakura S, Umebayasi H, Kurosawa R, Imagawa T, Mori M, Yokota S (2004) Hypersensitivity syndrome in two patients with Kawasaki disease treated with high dose immunoglobulin. J Kanagawa Med Assoc 31:209 (abstract)
Kawasaki T (1967) Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi 16:178–222
Newburger JW, Takahashi M, Beiser AS, Burns JC, Bastian J, Chung KJ (1991) A single intravenous infusion of gamma globulin as compared with four infusions in the treatment of acute Kawasaki syndrome. N Engl J Med 324:1633–1639
Sato A, Funabiki T (2008) A report of two cases with Kawasaki disease, who presented with fever, rash, liver dysfunction and agranulocytosis in the convalescent phase. J Pediatr Infect Dis Immun 20:3–7
Son MBF, Newburger JM (2011) Kawasaki disease. In: Kliegman RM, Stanton BF, Geme JWS, Schor NF, Behrman RE (eds) Nelson textbook of pediatrics, 19th edn. Elsevier, Philadelphia, pp 862–867
Vecchietti G, Kerl K, Prins C, Kaya G, Saurat JH, French LE (2006) Severe eczematous skin reaction after high-dose intravenous immunoglobulin infusion: report of 4 cases and review of the literature. Arch Dermatol 142:213–217
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Takeuchi, M., Oda, Y. & Suzuki, I. Maculopapular rash in the convalescent phase of Kawasaki disease: case series and literature review. Eur J Pediatr 172, 405–407 (2013). https://doi.org/10.1007/s00431-012-1898-y
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DOI: https://doi.org/10.1007/s00431-012-1898-y