Ewha Med J.  2016 Oct;39(4):133-136. 10.12771/emj.2016.39.4.133.

Kawasaki Disease with Optic Disc Swelling and Uveitis

• Kang JI
• Lee YS
• Lee SW
• Sohn S
• Hong YM

• KMID: 2356387
• DOI: http://doi.org/10.12771/emj.2016.39.4.133

Abstract

Kawasaki disease (KD) is the self-limited and multisystem vasculitis which accompanies many complications. Ophthalmic findings in KD are bilateral conjunctival injection, iridocyclitis, superficial keratitis, vitreous opacities and subconjunctival hemorrhage. Optic disc swelling is a rare ophthalmic complication in KD. We describe a 3-year-old boy who presented with 7 days of fever, both conjunctival injection without discharge, and right cervical lymph node enlargement of more than 1.5 cm. He was diagnosed as incomplete KD. He had no ocular symptom except bilateral conjunctival injection. On ophthalmic examination, he was diagnosed by anterior uveitis with optic disc swelling. The brain magnetic resonance imaging was performed and revealed no evidence of increased intracranial pressure. Echocardiography revealed the dilated right coronary artery up to 3.4 mm. Fever subsided and optic disc swelling was completely improved after intravenous immunoglobulin (2 g/kg) treatment. Optic disc swelling is a rare ophthalmic complication in KD.

Keyword

Mucocutaneous lymph node syndrome; Papilledema; Uveitis; Immunoglobulins

MeSH Terms

Brain
Child, Preschool
Coronary Vessels
Echocardiography
Fever
Hemorrhage
Humans
Immunoglobulins
Intracranial Pressure
Iridocyclitis
Keratitis
Lymph Nodes
Magnetic Resonance Imaging
Male
Mucocutaneous Lymph Node Syndrome*
Papilledema
Uveitis*
Uveitis, Anterior
Vasculitis
Immunoglobulins

Figure

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  Fig. 1 Two dimensional echocardiographic finding in Kawasaki disease. (A) An echocardiogram reveals dilatation of right coronary artery. (B) Left coronary artery is normal. RCA, right coronary artery; LCA, left coronary artery.

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  Fig. 2 Ophthalmoscopic examination in Kawasaki disease patient. This figure shows optic disc margin blunting of 360-degree in both eyes (A, B). The arrows indicate the optic disc margin blunting. A, right eye; B, left eye.

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  Fig. 3 Brain magnetic resonance imaging (T2-weighted axial scan). There is no evidence of abnormal signal lesion in the brain. No abnormal enhancing lesion is seen (A, B). A, Thalamus-basal ganglia level; B, Pons level.

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