Korean Journal of Pediatrics 2009;52(9):1029-1034.
Published online September 15, 2009.
A case of adolescent Kawasaki disease with Epstein-Barr virus-associated infectious mononucleosis complicated by splenic infarction
Byeong Sam Choi1, Bo Sang Kwon1, Gi Beom Kim1, Yoon Kyung Jeon2, Jung-Eun Cheon3, Eun Jung Bae1, Chung Il Noh1, Jung Yun Choi1, Yong Soo Yun1
1Departments of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
2Departments of Pathology, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
3Departments of Radiology, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
전염성 단핵구증과 비경색증이 동반된 청소년 난치성 가와사끼병 1예
최병삼1, 권보상1, 김기범1, 전윤경2, 천정은3, 배은정1, 노정일1, 최정연1, 윤용수1
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 병리학교실
3서울대학교 의과대학 영상의학교실
Correspondence: 
Eun Jung Bae, Email: eunjbaek@snu.ac.kr
Abstract
Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that affects children. There are few reports that describe the Epstein-Barr virus (EBV) as the possible infectious agent of KD. Here, we describe a case of KD in a 15- year-old boy complicated with giant coronary artery aneurysms, pericardial effusion, and splenic infarction. The clinical course of KD was refractory to intravenous gamma globulin and aspirin. Our patient also showed typical findings of concomitant EBV-associated infectious mononucleosis, such as hepatosplenomegaly and generalized lymphadenopathy, with EBV-positive atypical lymphoid hyperplasia. He improved dramatically after receiving intravenous methylprednisolone followed by oral prednisolone. Ultimately, the coronary artery aneurysms remained as the only sequelae. We report a rare case of adolescent KD with EBV-associated infectious mononucleosis and splenic infarction.
Key Words: Mucocutaneous lymph node syndrome, Epstein-Barr virus infection, Coronary artery disease, Splenic infarction, Corticosteroids


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