Korean J Pediatr.  2017 Oct;60(10):333-336. 10.3345/kjp.2017.60.10.333.

Acute pancreatitis in hand, foot and mouth disease caused by Coxsackievirus A16: case report

• Park B
• Kwon H
• Lee K
• Kang M

• KMID: 2393810
• DOI: http://doi.org/10.3345/kjp.2017.60.10.333

Abstract

Coxsackievirus A16 (CA16), which primarily causes hand, foot, and mouth disease (HFMD), is associated with complications, such as encephalitis, acute flaccid paralysis, myocarditis, pericarditis, and shock. However, no case of pancreatitis associated with CA16 has been reported in children. We report a case of CA16-associated acute pancreatitis in a 3-year-old girl with HFMD. She was admitted because of poor oral intake and high fever for 1 day. Maculopapular rashes on both hands and feet and multiple vesicles on the soft palate were observed on physical examination. She was treated conservatively with intravenous fluids. On the fourth hospital day, she had severe abdominal pain and vomiting. The serum levels of amylase and lipase were remarkably elevated (amylase, 1,902 IU/L; reference range, 28-100 IU/L; lipase, >1,500 IU/L; reference range, 13-60 IU/L), and ultrasonography showed diffuse swelling of the pancreas with a small amount of ascites. The real-time reverse transcription polymerase chain reaction result from a stool sample was positive for CA16. CA16 can cause acute pancreatitis, and should be considered in the differential diagnosis of abdominal pain in children with HFMD.

Keyword

Pancreatitis; Coxsackievirus A16; Hand; foot and mouth disease

MeSH Terms

Abdominal Pain
Amylases
Animals
Ascites
Child
Child, Preschool
Diagnosis, Differential
Encephalitis
Exanthema
Female
Fever
Foot
Foot-and-Mouth Disease
Hand*
Hand, Foot and Mouth Disease*
Humans
Lipase
Mouth Diseases
Myocarditis
Palate, Soft
Pancreas
Pancreatitis*
Paralysis
Pericarditis
Physical Examination
Polymerase Chain Reaction
Reference Values
Reverse Transcription
Shock
Ultrasonography
Vomiting
Amylases
Lipase