Two cases of Kawasaki disease complicated with multiple pulmonary nodules and literature review / 中华实用儿科临床杂志

ABSTRACT

Objective:To investigate the clinical features of Kawasaki disease complicated with multiple pulmonary nodules and to summarize the experience of diagnosis and treatment.Methods:Clinical data of 2 cases of Kawasaki disease complicated with multiple pulmonary nodules admitted to the Department of Respiratory, Beijing Children′s Hospital in 2019 were retrospectively analyzed, and relevant literature was reviewed.Results:The 2 cases were both 3-month-old infants, with fever as the main manifestation.Both were consistent with the diagnosis of Kawasaki disease, and the respiratory symptoms were mild or not obvious.Radiological examination revealed multiple pulmonary nodules, and the results of etiology, immunology and tumor-related exams were all negative.In the follow up stage after treatment, pulmonary nodules gradually disappeared.Among 10 cases of Kawasaki disease with pulmonary nodules (8 cases from previous studies and 2 cases from this report), 90% were 3-6-month-old babies, 80% were diagnosed with incomplete Kawasaki disease, and all patients presented more than 2 nodules in the lungs, with irregular distribution and different sizes.Besides, 80% of the 10 cases had coronary artery involvement of varying degrees.One patient died in the acute disease phase, while pulmonary nodules of the remaining patients disappeared in 12 days to 1 year.Conclusions:Kawasaki disease may be complicated with multiple pulmonary nodules, especially in young infants.Most of the patients present with incomplete Kawasaki disease and are prone to coronary artery lesions, which may be related to pulmonary vascular involvement caused by Kawasaki disease.The prognosis is mostly good, and pulmonary nodules can disappear naturally with the treatment and course of Kawasaki disease.