SWY To, CLS Yan, NC Fong, CW Leung

Abstract

Kawasaki disease shock syndrome (KDSS) is a newer entity being better recognised recently, which is defined as Kawasaki disease features plus systolic hypotension or clinical signs of poor perfusion. Patients with KDSS typically have more heightened levels of inflammatory markers and greater risks of coronary artery abnormalities, mitral regurgitation and persistent myocardial dysfunction. They also have greater likelihood of intravenous immunoglobulin (IVIG) resistance requiring additional anti-inflammatory treatment. We report two cases of KDSS presenting with shock, both with IVIG resistance and coronary arteries involvement. Clinicians should maintain high index of suspicion for KDSS to avoid delay in diagnosis and to facilitate timely treatment by IVIG.