Kawasaki disease with G6PD deficiency: A case report and literature review

Abstract

Objective: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. Aspirin is widely used in KD management, but its use in glucose-6-phosphate dehydrogenase (G6PD) deficiency is challenging due to the risk of hemolysis. This report discusses the management of KD in a child with G6PD deficiency.

Case presentation: A 2-year-7-month-old girl presented with fever, jaundice, and rash. She developed classic KD symptoms, including conjunctival injection, strawberry tongue, and limb edema, with laboratory findings of elevated inflammatory markers, anemia, and thrombocytosis. Diagnosed with KD, she was treated with IVIG, dipyridamole, and low-dose aspirin to mitigate hemolysis risk. The patient recovered without complications, and follow-up revealed no coronary artery abnormalities.

Conclusions: Low-dose aspirin combined with other antiplatelet agents, such as dipyridamole, may have been safely used in this patient with G6PD deficiency. Individualized treatment strategies are essential, and further research is needed to optimize aspirin use in this population.