A child with Kawasaki disease successfully treated with Chinese herbal medicine: A case report with 12-month follow up

Abstract

Abstract Introduction Kawasaki disease (KD) is an acute febrile and eruptive disease with systemic vasculitis of unknown etiology presenting predominantly in early childhood, most commonly in those under 5 years old. Although KD has been reported in almost all populations, it is especially common in North East Asia such as Japan, Korea and Taiwan which has the highest incidence worldwide that in contrast to the US, Europe and Australia. It is reported that more than 1 in 100 Japanese have had KD by 12 years of age. KD is a potentially life-threatening condition because it can cause serious pediatric-acquired heart disease such as asymptomatic coronary artery ectasia or an aneurysm. Intravenous immunoglobulin (IVIG) is a routine and effective treatment for KD and significantly reduces risk of coronary artery abnormalities during the acute phase of illness from approximately 15%–25% to 5%–8%. In spite of its effectiveness, some patient do not respond to this therapy and still develop coronary aneurysms. Chinese herbal medicine (CHM) as a therapy alone for KD was rare. The success of this patient with KD treated by CHM provided a new way of thinking for harmonizing Eastern-Western drug for KD and the potential utilization of CHM as a source of new drugs could be an alternative. Clinical features and outcome A 17 month-old boy suffered from persistent fever, poor appetite, vomiting diarrhea, slight cough, running nose and throat congestion for 2 days and was diagnosed with an upper respiratory infection. He had taken cefprozil suspension plus ankahuangmin 2 days for his symptoms before his final diagnosis of KD, but it was unsuccessful. He continued to have a fever, in addition, he presented with bilateral bulbar conjunctival congestion without exudate, labial and lingual erythema and was diagnosed with KD before his first CHM visit, his parents refused to continue receiving Western medicine. Therefore, his parents sought CHM for further intervention. His symptoms subsided, and the blood tests, electrocardiogram (ECG) and echocardiographies show completely normal after regular therapy with Xiao Chai Hu Tang (小柴胡汤) combined with Bu Yang Huan Wu Tang (补阳还五汤), Huang Lian Jie Du Tang (黄连解毒汤), and Wu Ling San (五苓散) for approximately 21 days. Neither complications nor side-effects were noted during the CHM treatment. Conclusions In this case, CHM may be an effective alternative therapy for the treatment of KD, and furthermore, may also be applied as an option to salvage failed intravenous immunoglobulin procedures. Further controlled trials are warranted to determine whether this is an effective treatment option for other cases of KD.