Hepatitis colestásica como forma de presentación de Enfermedad de Kawasaki atípica: reporte de un caso

Kawasaki disease (KD) is an acute, self-limiting febrile illness and is the leading cause of paediatric acquired heart disease in developed countries. It presents with fever greater than five days, oral mucosal changes, lymphadenopathy, rash, limb involvement and/or conjunctival injection. Liver involvement may range from mildly increased transaminases to severe cholestatic hepatitis and/or vesicular hydrops.We present a 5-year-old female patient whose symptoms began with acute febrile cholestatic hepatitis, with no apparent cause. On the 14th day of evolution, she added non-purulent conjunctival injection, periungual desquamation and thrombocytosis. In view of the suspicion of atypical KD, an echocardiogram was performed, which revealed coronary involvement. It is important to take into account the variability of symptoms in KD, as the rapid establishment of appropriate treatment reduces the appearance and severity of associated complications.