Kawasaki disease complicated by mild encephalopathy with a reversible splenial lesion (MERS)

• Published in: Journal of the neurological sciences 2012-04, Vol.315 (1), p.167-169
• Main Authors: Takanashi, Jun-ichi, Shirai, Kentaro, Sugawara, Yuji, Okamoto, Yoko, Obonai, Toshimasa, Terada, Hitoshi
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiac aneurysm; Child; Child, Preschool; Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS); Corpus callosum; Corpus Callosum - pathology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Delirium; Diffusion-weighted image; Encephalitis - complications; Encephalitis - diagnosis; Female; Humans; Kawasaki disease; Male; Medical sciences; Mucocutaneous Lymph Node Syndrome - complications; Mucocutaneous Lymph Node Syndrome - diagnosis; Neurology
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2011.11.022

Abstract We reported four patients (2 to 10 years) with Kawasaki disease complicated by clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). All were treated with γ-globulin (2 to 6 g/kg) after the diagnosis of Kawasaki disease, the fever being alleviated between day 6 and 25. One of two patients exhibiting a poor response to γ-globulin had a cardiac aneurysm as a sequela. Their neurological manifestations (delirious behavior and drowsiness), laboratorial hyponatremia, and radiological abnormalities completely disappeared. It is important for pediatricians to acknowledge that MERS can be observed in patients with Kawasaki disease, especially in older children, and that they might be at high risk for cardiac abnormalities.