Multiple Systemic Arterial Aneurysms in Kawasaki Disease.

Kawasaki disease is a self-limiting systemic vasculitis that can lead to various cardiac complications, including coronary dilatation and aneurysms. However, systemic aneurysms are uncommon and only occur in rare cases. In this instance, we present the case of an eight-week-old infant who presented to the emergency department with fever, loose motion, and neck swelling, ultimately diagnosed with Kawasaki disease accompanied by multiple systemic arterial aneurysms. This case highlights the potential for Kawasaki disease to cause systemic aneurysms and emphasizes the importance of recognizing and monitoring this rare complication in patients diagnosed with Kawasaki disease.

Prolonged Cholestasis Following Acute Hepatitis A Infection: Case Report and a Review of Literature.

Prolonged cholestasis is a rare complication of hepatitis A infection, characterized by a protracted, indolent course with persistent symptoms of pruritus and malabsorption lasting for several months. A 14-year-old girl, previously treated for acute hepatitis A, presented with yellowing of the eyes. An evaluation of her liver function revealed conjugated hyperbilirubinemia, and a liver biopsy confirmed hepatitis with cholestasis. Fortunately, she responded well to conservative treatment and recovered successfully.

Adverse Events of the BCG (Bacillus Calmette-Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of Immunity.

BACKGROUND: The Bacillus Calmette-Guérin (BCG) and rotavirus vaccines are live-attenuated preparations. In the United Arab Emirates, these products are universally administered to the young infants. This unguided practice does not account for the children with immunodeficiency, which frequently manifests after the administration of these vaccines. We present here a young infant with immunodeficiency that developed disseminated tuberculosis infection and severe diarrhea due to these improper immunizations. Case Presentation. This young infant was diagnosed at six months of age with "immunodeficiency type 19" (MIM#615617) due to homozygous nonsense variant, NM_000732.4 (CD3D):c.128G > A, p.Trp43∗ (variation ClinVar#VCV000643120.1; pathogenic). This variant creates premature stop-gain in CD3D (CD3 antigen, delta subunit, autosomal recessive; MIM#186790), resulting in loss-of-function. He also had "X-linked agammaglobulinemia" (MIM#300755) due to hemizygous missense variant, NM_001287344.1 (BTK):c.80G > A, p.Gly27Asp (novel). He had a sibling who passed away in infancy of unknown disease and family members with autoimmune disorders. Despite these clear clues, he was immunized with BCG at birth and rotavirus at 2 and 4 months. He was well in the first four months. He then developed high-fever, lymphadenopathy, and refractory diarrhea. Stool was positive for rotavirus, and lymph node biopsy showed acid-fast bacilli, consistent with tuberculosis lymphadenitis. These infections were serious and markedly complicated his clinical course, which included bone marrow transplantation from a matched sibling. CONCLUSIONS: These unfortunate events could have been avoided by compiling the available clinical information. This patient underscores the importance of implementing proper policies for BCG and rotavirus vaccinations. International registries of adverse events of universally administered vaccines are crucial.