Journal of the Korean Pediatric Society 1999;42(7):1014-1018.
Published online July 15, 1999.
A Case of Kawasaki Disease Diagnosed with the Assistance of Ophthalmologic Examination
Soo-Jung Ha1, Kyung-Yil Lee1, Sang-Won Cha1, Dong-Joon Lee1, Ji-Whan Han1, Kyung-Tai Whang1, Ik-Soo Kim2
1Department of Pediatrics, The Catholic University of Korea, Medical College, Seoul, Korea
2Department of Ophthalmology, The Catholic University of Korea, Medical College, Seoul, Korea
안과적 검사가 진단에 도움을 준 가와사끼병 1례
하수정1, 이경일1, 차상원1, 이동준1, 한지환1, 황경태1, 김익수2
1가톨릭대학교 의과대학 소아과학교실
2가톨릭대학교 의과대학 안과학교실
Correspondence: 
Kyung-Yil Lee, Email: 1
Abstract
Kawasaki disease is a systemic vasculitis in which bilateral nonexudative conjunctivitis and anterior uveitis are common early findings in the course of illness. We report an eleven-year-old boy with atypical Kawasaki disease who was diagnosed with the help of an ophthalmologic examination. The patient presented with fever, epigastric pain with vomiting, erythematous rash, and severe bilateral conjunctival injection, a red throat without strawberry tongue and scarletiniform rash on the chest and back. Cervical lymphadenopathy and changes in the extremities were not shown. Slit lamp biomicroscopic examination three days after admission revealed bilateral bulbar conjuctival injection, superficial punctate erosions, and aquous humor inflammatory reaction(3+/4+ cells and 2+/4+ flare), a manifestation of anterior uveitis. After receiving two consecutive doses of intravenous immunoglobulin(IVIG, total 2.4g/kg) the boy showed no response. He was subsequently treated with high dose methylprednisolone(14mg/kg) intravenously. Two-dimensional echocardiography 2 weeks after admission showed aneurysmal changes on the proximal parts of the left main coronary artery(4.5mm) and right coronary artery(4.0mm). Slit lamp examination early in the course of the illness can help in the diagnosis of Kawasaki disease.
Key Words: Kawasaki disease, Anterior uveitis, Slit lamp examination


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