Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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Kawasaki Disease Shock Syndrome with Acute Kidney Injury and Hypertension

급성 신손상을 동반한 가와사키 쇼크증후군 1예

  • Choi, Jae Hong (Department of Pediatrics, Jeju National University Hospital, Jeju National University College of Medicine) ;
  • Kim, Yoon-Joo (Department of Pediatrics, Jeju National University Hospital, Jeju National University College of Medicine) ;
  • Kim, Young Don (Department of Pediatrics, Jeju National University Hospital, Jeju National University College of Medicine) ;
  • Han, Kyoung Hee (Department of Pediatrics, Jeju National University Hospital, Jeju National University College of Medicine)
  • 최재홍 (제주대학교 의과대학 제주대병원 소아청소년과) ;
  • 김윤주 (제주대학교 의과대학 제주대병원 소아청소년과) ;
  • 김영돈 (제주대학교 의과대학 제주대병원 소아청소년과) ;
  • 한경희 (제주대학교 의과대학 제주대병원 소아청소년과)
  • Received : 2016.10.03
  • Accepted : 2016.11.15
  • Published : 2017.08.25
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Abstract

Kawasaki disease (KD) is an acute febrile mucocutaneous lymph node syndrome that commonly presents with stable hemodynamic status during the acute phase. An 8-year-old boy initially presented with severe hypotension and acute kidney injury. He was placed in the intensive care unit and was diagnosed with KD. Observed clinical features were defined as KD shock syndrome. His coronary artery was dilated during the subacute phase. Furthermore, he was given anti-hypertensive medications, owing to hypertension as an unusual complication of KD. We knew the importance of monitoring for blood pressure considering vasculitis as an aspect of the main pathogenesis of KD.

가와사키병은 다른 원인이 없는 발열과 함께 피부점막에 특징적인 병변을 보이는, 소아에서는 비교적 흔한 질환으로 일반적으로 급성기에는 혈역학적으로 안정적이다. 저자들은 심한 저혈압과 함께 급성 신손상이 있는 상태에서 내원한 8세 남아가 치료 중에 가와사키병으로 진단된 증례를 경험하였다. 최근에는 가와사키병 초기에 불안정한 혈역학적 상태를 가와사키병 쇼크증후군이라는 개념으로 정의하고 있다. 환아는 면역글로불린 치료 후 임상적으로 회복되었으나 관상동맥 확장 합병증이 확인되어 아스피린을 복용하고 있으며, 가와사키병의 합병증으로서는 비교적 드문 고혈압이 확인되어 베타 차단제를 사용하고 있다. 본 증례를 통해 가와사키병 쇼크증후군의 임상 양상을 알고, 혈관염이라는 가와사키병의 특성을 고려해볼 때 혈압 모니터링의 중요성을 깨닫게 되었다.

Keywords

References

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