Para-aortic Lymphadenopathy Associated with Kawasaki Disease

Background: Kawasaki disease is an acute vasculitis that occurs mainly in children. Cervicallymphadenopathy is one of the major presenting manifestations of Kawasaki disease. Wereport a case of Kawasaki disease with para aortic lymphadenopathy, as an unusual feature inthis disease. Case Presentation: This 2.5 year old girl presented with persistent high grade fever,erythematous rash, bilateral non purulent conjunctivitis, red lips, and edema of extremities.Laboratory results included an elevated erythrocyte sedimentation rate, leukocytosis, anemia,and positive C-reactive protein. On second day after admission she developed abdominal pain.Ultrasonography of abdomen revealed multiple lymph nodes around para aortic area, thelargest measuring 12mm6mm. Treatment consisted of aspirin and high dose intravenous γ-globulin. Ultrasonography and CT scan of abdomen performed one week later showeddisappearance of the lymph nodes. Conclusion: There are few previous reports of lymphadenopathy in unusual sites such asmediastinum in Kawasaki disease. Para aortic lymph nodes enlargement might be an associatedfinding with acute phase of Kawasaki disease. In these patients a close observation andultrasonographic follow up will prevent unnecessary further investigation