Abstract
A 7-year-old girl had presented with high body temperature and joint pain which continued for 3 days. Because of the prolonged history of unexplained fever, rash, bilateral nonpurulent conjunctival injection, oropharyngeal erythema, strawberry tongue, and extreme of age, incomplete Kawasaki disease was considered and started on an intravenous immunoglobulin infusion. Six days after this treatment, patient was referred to eye clinic with decreased vision and photophobia. Visual acuity was reduced to 20/40 in both eyes. Slit-lamp examination revealed bilateral diffuse corneal punctate epitheliopathy and anterior stromal haze. Corneal epitheliopathy seemed like crystal deposits. One day after presentation, mild anterior uveitis was added to clinical picture. All ocular findings disappeared in one week with topical steroid and unpreserved artificial tear drops. We present a case who was diagnosed as incomplete Kawasaki disease along with bilateral diffuse crystalline-like keratopathy. We supposed that unusual ocular presentation may be associated with intravenous immunoglobulin treatment.
Highlights
Kawasaki disease (KD) is an acute, self-limiting systemic vasculitis of unknown etiology that affects the small- and medium-sized blood vessels of the body, the coronary arteries, which predominantly affects children at 6 months to 5 years of age [1]
Diagnosis of incomplete KD is vital for timely infusion of intravenous immunoglobulin (IVIG) to prevent coronary complications
We present a case who was diagnosed as incomplete Kawasaki disease along with bilateral diffuse crystalline-like keratopathy
Summary
Kawasaki disease (KD) is an acute, self-limiting systemic vasculitis of unknown etiology that affects the small- and medium-sized blood vessels of the body, the coronary arteries, which predominantly affects children at 6 months to 5 years of age [1]. It was first described by Kawasaki in 1967 in Japan. Some patients who are diagnosed with “incomplete” KD do not fulfill the clinical criteria for classical KD Such patients are usually at extreme ages and are more at risk for developing an aneurysm of the coronary arteries. We supposed that unusual ocular presentation may be associated with intravenous immunoglobulin treatment
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