Kawasaki disease shock syndrome with acute pancreatitis as the initial presentation complicated with multiple system dysfunction:a case report
SUN Chongrui
Abstract：Objective To summarize the clinical features of Kawasaki disease shock syndrome(KDSS)with multi-ple system dysfunction presenting with acute pancreatitis as the initial symptom,so as to further deepen the understanding of KDSS with multiple system dysfunction.Methods A retrospective analysis was performed on the clinical manifesta-tions,physical examination,laboratory tests,imaging studies,and treatment process of a case of KDSS child.Literature was retrieved and analyzed for KDSS children with multiple complications presenting gastrointestinal symptoms as the ini-tial manifestation.Results The child developed acute pancreatitis as the initial symptom,with KDSS appearing at the onset accompanied by myocarditis,acute heart failure,arrhythmia,hypercoagulable state,liver dysfunction,electrolyte disturbances,acute kidney injury,neurological damage and other multi-system damage.The final diagnosis was confirmed as KDSS with multisystem dysfunction.After timely treatment with human immunoglobulin(IVIG),hormone,plasma ex-change and other comprehensive treatment,the child's condition improved significantly.A total of 9 cases were retrieved in the literature review,with 4 cases presenting concurrent liver injury,2 cases of cholestasis,2 cases of acute appendici-tis,1 case of pancreatitis,1 case of intestinal obstruction,and 1 case of intestinal perforation.Coronary artery dilation oc-curred in 7 cases,but follow-up data showed that only 3 children maintained this condition,while the remaining children's coronary arteries became normal.Two cases developed heart failure during the course of the disease,though all cardiac functions returned to normal later.Conclusions Acute pancreatitis-associated KDSS with multisystem dysfunction is a rare condition.Early identification and timely,effective symptomatic treatment are crucial for improving prognosis in pedi-atric patients with KDSS complicated with multi-system impairment.Once KDSS is diagnosed,early anti-inflammatory and anti-shock therapies can significantly improve outcomes.
Keywords：Kawasaki diseaseKawasaki disease shock syndromeshockacute pancreatitismultiple system dysfunction
Publication Date：2025-09-25
Online Publishing Date：2025-10-22(First online date of this platform, not the publication date of the document)
Pages：6( 70-75 )