A 2-month-old boy with hemolytic anemia and reticulocytopenia following intravenous immunoglobulin therapy for Kawasaki disease: a case report and literature review

• Published in: Clinical and experimental pediatrics Vol. 59; no. Suppl 1; pp. S60 - S63
• Main Authors: Kim, Na Yeon, Kim, Joon Hwan, Park, Jin Suk, Kim, Soo Hyun, Cho, Yeon Kyung, Cha, Dong Hyun, Kim, Ki Eun, Kang, Myung Suh, Lim, Kyung Ah, Sheen, Youn Ho
• Format: Journal Article
• Language: English
• Published: Korea (South) Clinical and Experimental Pediatics / Korean Pediatric Society 01.11.2016; The Korean Pediatric Society; Korean Pediatric Society; 대한소아청소년과학회
• Subjects: Anemia; Apoptosis; Blood; Blood platelets; Bone marrow; Case Report; Conflicts of interest; Cytomegalovirus; Electrocardiography; Fever; Hemoglobin; Hemolysis; Herpes viruses; Immunoglobulins; Iron; Kawasaki disease; Laboratories; Patients; Reticulocytes; Rubella; Ultrasonic imaging; Viral infections; 소아과학; Hemolysis; Reticulocytes; Kawasaki disease; Anemia
• ISSN: 1738-1061; 2092-7258; 2092-7258; 2713-4148
• DOI: 10.3345/kjp.2016.59.11.S60

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.