PMC7380064_01
Schema of the course of this case. After admission and treatment with immunoglobulin, moderate fever sustained. Additional immunoglobulin combined with prednisolone was administered, which relieved fever; however, the serum Na level began to decrease, and the consciousness level worsened. Water restriction resulted in worsened hyponatremia. Thereafter, Na loading was started and resulted in improved consciousness and bladder-rectal function. BT, body temperature; BP, blood pressure; s-osm, serum osmolality; u-osm, urine osmolality; EEG, electroencephalogram; MRI, magnetic resonance imaging; KD, Kawasaki disease; B-R disorder, bladder-rectal disorder; IVIG, intravenous immunoglobulin; PSL, prednisolone; ASA, acetylsalicylate; ARB, angiotensin receptor blocker.
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F1
Intravenous immunoglobulin (IVIG) treatment and oral aspirin were started on day 2 under the diagnosis of KD (Figure 1).
Electroencephalogram recorded on day 8. Encephalopathy is suspected because of the diffuse slowing of the background activity.
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F2
Although the brain magnetic resonance imaging (MRI) did not show abnormalities on day 7, the electroencephalogram (EEG) showed diffuse slowing of the background activity, and acute encephalopathy was considered on day 8 (Figure 2).