Abstract Ref Number = APCP769
METHYLPREDNISOLONE AS AN ALTERNATIVE THERAPY FOR KAWASAKI DISEASE CASE SERIES
Yudha Fadhol Arafah Yasrizal,Sasmito Nugroho,Noormanto
Gadjah Mada University
Background : Kawasaki disease (KD) is the leading cause of childhood acquired heart disease in the developed world. In developing countries, not every province had IVIG for therapy. It is important to have an alternative therapy in such cases. We present case series KD with methylprednisolone therapy.
Case Presentation Summary : First case, at Banyumas district hospital, a sixteen month old boy had fifth day high fever, erythema on hand, feet and all of body, red lips, strawberry tongue, conjunctival injection and desquamation in perineal area. On investigation he had neutrophilia, hypoalbuminemia, and high level CRP. Echocardiography resulted minimal pericardial effusion. Because limitation of IVIG, patient was treated with methylprednisolone dose 30mg/BW/day for 3 day, and then switch to oral dose 1mg/BW/day for a week and then tap off dose. Second day after administration of methylprednisolone, fever relieved and erythema graduate disappear. Patient discharge at fifth day of hospitality. Second case, at Dr Sardjito general hospital, a twenty two month old girl had fifth day high recurrent fever with conjunctivitis and erythema all of body came to private hospital for hospitality with diagnosed Measles and discharge after three days. A second week patient came to our pediatric cardiologist referral from pediatrician because desquamation all of the body and suspected with Kawasaki disease. On investigation, he had leukocytosis and high level CRP. Echocardiography resulted left coronary artery aneurism. Patient was treated with methylprednisolone dose 30mg/BW/day for 3 day. Evaluation echocardiography on third day therapy was normal. Patient discharge at fourth day of hospitality. Figure 1. Strawberry tongue (before and after therapy)
Learning Points/Discussion : Patient with Kawasaki disease with methylprednisolone therapy had greater benefit but more test are needed.
Keywords: Kawasaki disease Corticosteroid Methylprednisolone