International Journal of Clinical Pediatrics, ISSN 1927-1255 print, 1927-1263 online, Open Access
Article copyright, the authors; Journal compilation copyright, Int J Clin Pediatr and Elmer Press Inc
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Case Report

Volume 10, Number 1, March 2021, pages 10-17

Kawasaki Disease Shock Syndrome: A Challenging Diagnosis


Figure 1.
Figure 1. Rash of the lower limbs.
Figure 2.
Figure 2. Pulmonary ultrasound showing anechogenic pleural effusion with sinusoid sign (M-mode). The sinusoid sign (*) is a dynamic sonographic sign, present when respiratory variation decreases the distance between the parietal and visceral pleura, when separated by a pleural effusion.
Figure 3.
Figure 3. Transthoracic echocardiography demonstrating an aneurysmatic dilatation (4.7 mm) at the beginning of the right coronary artery (white arrow).
Figure 4.
Figure 4. Transthoracic echocardiography demonstrating a rosary aneurysmatic dilatation of the left coronary artery (white arrow).
Figure 5.
Figure 5. Transthoracic echocardiography demonstrating a dilatation of left main coronary artery (3.7 mm).
Figure 6.
Figure 6. Abdominal ultrasound, with thickening of the terminal ileum and large amount of peritoneal effusion (++).


Table 1. Summary of Blood Results During Inpatient Admission
BUN: blood urea nitrogen; CRP: C-reactive protein; GOT: glutamic oxaloacetic transaminase; GPT: serum glutamic pyruvic transaminase; INR: international normalized ratio; LDH: lactate dehydrogenase; NT-proBNP: N-terminal pro B-type natriuretic peptide.
White cell count (× 109/L)26.4734.2727.9713.5810.258.838.938.67
Neutrophils (× 109/L)22.3127.4225.1510.123.972.574.473.81
Lymphocytes (× 109/L)3.525.142.553.15.715.614.004.03
Hemoglobin (g/L)9.37.810.
Platelets (× 109/L)1184721550215251327301
CRP (mg/L)28.83018.1413.
GOT/GPT (U/L)537/84222/111250/14440/7231/4254/6931/5019/34
Fibrinogen (mg/dL)7221201502499387--
Albumin (U/L)2123252930273032
Creatinine (mg/dL)0.520.770.600.400.420.340.320.36
BUN (mg/dL)31602121151312
LDH (U/L)537873687310305222-212
Triglycerides (mg/dL)76105------
Ferritin (ng/mL)7222,2175,070822----
Troponin (ng/L)-404.4---
NT-proBNP (ng/L)-> 35,000---4,875.4183.6994.2