ABSTRACT
We report the case of a 3-years-old boy who developed severe hyponatremia and unconsciousness during an episode of Kawasaki disease (KD). He was diagnosed with cerebral salt-wasting syndrome (CSWS), which has not previously been reported as a complication of KD. He was diagnosed with KD with fever and four clinical signs and received intravenous immunoglobulin (IVIG) on the day after onset. Hyponatremia had been observed, and it worsened after IVIG. At first, syndrome of inappropriate antidiuretic hormone secretion (SIADH) was suspected, but his hyponatremia did not improve by restriction of water intake. The patient's consciousness level decreased along with the worsening hyponatremia. Electroencephalography revealed abnormal electrical discharge concordant with acute encephalopathy. Laboratory data showed hypouricemia with high fractional excretion of uric acid (FEUA), in addition to a negative balance of both Na and water. We diagnosed KD complicated with CSWS. The patient improved promptly with appropriate Na supplementation and water correction.
ABSTRACT
A Rh(III)-catalyzed annulative coupling of 3,5-diarylisothiazoles and alkynes is reported. The N-S bond in the isothiazole ring acts as an internal oxidant to regenerate the Rh(III) species in combination with an external Cu(II) oxidant, and the corresponding 1:2 coupling products are obtained. The remarkable difference in the reaction outcome between isothiazoles and the relevant isoxazoles has been investigated by DFT calculations, revealing that the relative stability of the enolate intermediates dictates the product selectivity.
