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PEDIATRICS Vol. 101 No. 6 June 1998, p. e9

ELECTRONIC ARTICLE:
Periorbital Vasculitis Complicating Kawasaki Syndrome in an Infant

Received Oct 20, 1998; accepted Feb 13, 1998.

Michael W. Felz*

Arif Patni*

Steven E. BrooksDagger , §

Rachel A. Tesser§

Departments of * Family Medicine, Dagger  Pediatrics, and § Ophthalmology Medical College of Georgia Augusta, GA 30912

Periorbital vasculitis is a previously unreported complication of Kawasaki syndrome (KS). We describe an infant with severe KS refractory to initial management with salicylate and intravenous immunoglobulin (IVIG). Retreatment with IVIG and high-dose pulsed steroids was required for persistent fever and inflammatory manifestations. Despite aggressive medical therapy, a large left coronary artery aneurysm developed. After apparent complete KS remission, acute periorbital vasculitis developed in the left upper eyelid and orbit, requiring operative intervention for diagnosis and high-dose pulsed steroids for therapy. The significance of this previously unreported ophthalmic complication of KS is reviewed, along with a discussion of the role of steroids in KS manifestations refractory to IVIG.

Key words: Kawasaki syndrome, periorbital vasculitis.


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