Kawasaki disease with nephrotic syndrome : a case report

Kawasaki disease (KD) is systemic inflammatory disease that occurs predominantly in children younger than five years. In which multiple organ damage can be developed, renal manifestations are rare in KD, especially nephrotic syndrome (NS). Several cases of NS in KD have been reported with some kind of complications, and only one case of a patient with KD associated with steroid-resistant NS has been reported with a renal biopsy available to date, with the patient ultimately dying of chronic renal failure. We report a case of a 5-year-old boy who presented with typical KD symptoms (fever, nonpurulent conjunctivitis, fissured lips, strawberry tongue, peripheral edema, desquamation of fingers and crissum, and multiple lymphadenopathies) and developed NS without any other complication. A renal biopsy was available in this case performing as mesangioproliferative glomerulonephritis (MsPGN). The diagnosis of the case was KD presenting with NS. And the patient was treated with intravenous immunoglobulins, aspirin, dipyridamole, antibiotics, and steroid therapy. To date he has maintained long-term remission. The result shows that a common immune-mediated damage might be the possible mechanism for KD with NS.