Kawasaki disease shock syndrome with extreme leukemoid reaction mimicking hematologic malignancy in an IVIG-resistant child: A case report

This case emphasizes that KDSS with leukemoid reaction may mimic hematologic malignancy, delaying appropriate immunomodulatory therapy. Extreme leukocytosis (≥70 × 109/L) should not exclude KDSS, especially in children with unexplained fever and shock. Early recognition, adjunctive corticosteroid therapy, and individualized anticoagulation strategies are critical to prevent misdiagnosis and improve outcomes.