Belgian Journal of Paediatrics
Febrile cholestasis with mucocutaneous signs in a 13-year old during COVID-19 pandemic: a forgotten intravenous immune globulin response
Vol. 23 No. 2 (2021), Case reports
Vol. 23 No. 2 (2021)

Febrile cholestasis with mucocutaneous signs in a 13-year old during COVID-19 pandemic: a forgotten intravenous immune globulin response

Case reports
Published 2021-07-11 — Updated on 2023-01-18
Eline Lambert
Department of Pediatrics, University Hospitals Leuven, Belgium
Koen Kaïret
Department of Pediatrics, AZ Sint-Jozef Malle, Malle, Belgium
Liesbet Vercammen
Department of Pediatrics, AZ Turnhout, Turnhout, Belgium
Bert Suys
Department of Pediatric Cardiology, GZA, Antwerp, Belgium
Luc Pattyn
Department of Pediatrics, AZ Turnhout, Turnhout, Belgium

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Keywords

COVID-19
incomplete Kawasaki disease
intravenous immunoglobulin
febrile cholestasis

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How to Cite

Lambert, E., Kaïret, K., Vercammen, L., Suys, B., & Pattyn, L. (2023). Febrile cholestasis with mucocutaneous signs in a 13-year old during COVID-19 pandemic: a forgotten intravenous immune globulin response. Belgian Journal of Paediatrics, 23(2), 146–147. Retrieved from http://belgjpaediatrics.com/index.php/bjp/article/view/152 (Original work published July 11, 2021)
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Abstract

Intravenous immune globulins (IVIG) are increasingly used in Kawasaki-like cases possibly related to coronavirus disease 2019 (COVID-19), generally with striking clinical response.  We describe a teenager presenting febrile cholestasis, along with coronary aneurysm and other criteria fulfilling incomplete Kawasaki disease. The girl was treated with high dose acetylsalicylic acid and IVIG transfusion. Laboratory work-up revealed hepatitis antibodies. However, this result was obtained after IVIG and is considered as passively transferred IgG’s from blood donors.  Especially during COVID-19 pandemic, clinicians should be familiar with unusual Kawasaki presentations as febrile cholestasis, as well as inconclusive serology after the desired IVIG therapy.

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