What dose of intravenous immunoglobulin should be administered in Kawasaki disease with suspected systemic capillary leak syndrome?: Comment on: Shock: An unusual presentation of Kawasaki disease (Eur J Pediatr. 2011 Jul; 170(7):941-3)

摘要

We read with great interest the contribution by Thabet et al. [6]. They reported an unusual case of Kawasaki disease (KD) presenting with hypotensive shock in a 5-month-old infant. Although intravenous immunoglobulins (IVIG) were initially infused with high suspicion of KD, giant coronary aneurysms occurred 16 days later, and the condition was considered as an IVIG-resistant form of KD. Reading the case report, however, we suspected a systemic capillary leak syndrome (SCLS) because of persistent hypoalbumi-nemia in this patient.The SCLS is a rare disease of reversible plasma extravasation and vascular collapse accompanied by hypo-albuminemia due to increased vascular leakage [1]. Patients with SCLS can experience shock and noncardiogenic edema that are treated with vasopressor therapy and colloid solutions for their osmotic effects.