Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A 2-month-old boy with hemolytic anemia and reticulocytopenia following intravenous immunoglobulin therapy for Kawasaki disease: a case report and literature review

  • Kim, Na Yeon (Department of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Kim, Joon Hwan (Department of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Park, Jin Suk (Department of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Kim, Soo Hyun (Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University) ;
  • Cho, Yeon Kyung (Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University) ;
  • Cha, Dong Hyun (Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University) ;
  • Kim, Ki Eun (Department of Pediatrics, CHA Gangnam Medical Center, CHA University) ;
  • Kang, Myung Suh (Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University) ;
  • Lim, Kyung Ah (Department of Pediatrics, CHA Gangnam Medical Center, CHA University) ;
  • Sheen, Youn Ho (Department of Pediatrics, CHA Gangnam Medical Center, CHA University)
  • Received : 2014.07.22
  • Accepted : 2014.10.03
  • Published : 2016.11.15
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Abstract

Herein, we report a rare case of hemolytic anemia with reticulocytopenia following intravenous immunoglobulin therapy in a young infant treated for Kawasaki disease. A 2-month-old boy presented with fever lasting 3 days, conjunctival injection, strawberry tongue, erythematous edema of the hands, and macular rash, symptoms and signs suggestive of incomplete Kawasaki disease. His fever resolved 8 days after treatment with aspirin and high dose infusion of intravenous immunoglobulin. The hemoglobin and hematocrit decreased from 9.7 g/dL and 27.1% to 7.4 g/dL and 21.3%, respectively. The patient had normocytic hypochromic anemia with anisocytosis, poikilocytosis, immature neutrophils, and nucleated red blood cells. The direct antiglobulin test result was positive, and the reticulocyte count was 1.39%. The patient had an uneventful recovery. However, reticulocytopenia persisted 1 month after discharge.

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References

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