A 9-year-old boy with Kawasaki disease shock syndrome developed acute dyspnea during IVIG administration requiring invasive mechanical ventilation and bronchoscopy, but recovered completely with no coronary dilatation or pulmonary fibrosis at 1-month follow-up.
A 9-year-old boy presented with fever, neck mass, and rash and was diagnosed with Kawasaki disease shock syndrome (KDSS), a severe complication of Kawasaki disease.
The patient developed acute dyspnea during intravenous immunoglobulin (IVIG) administration, requiring urgent invasive mechanical ventilation and bronchoscopy.
The patient was successfully weaned off mechanical ventilation and recovered completely.
The relationship between pulmonary complications in this case and transfusion-related acute lung injury (TRALI) or transfusion-associated circulatory overload (TACO) remains unclear.
Early aggressive management and comprehensive treatment were associated with favorable prognosis in this case of KDSS with pulmonary involvement.
This research describes a rare and serious case of a 9-year-old boy with Kawasaki disease — an inflammatory condition that causes blood vessel swelling throughout the body — who developed two uncommon and dangerous complications at the same time. The child developed Kawasaki disease shock syndrome (KDSS), where the body goes into shock, and also developed severe breathing problems while receiving a standard treatment called intravenous immunoglobulin (IVIG), a blood-derived medication given through a vein. The breathing crisis was so severe it required a breathing machine (mechanical ventilator) and a procedure to look inside the airways (bronchoscopy). Despite the severity of the situation, the child recovered fully and was successfully taken off the ventilator relatively quickly. A follow-up check one month after leaving the hospital showed no damage to the heart's coronary arteries (a known concern with Kawasaki disease) and no scarring in the lungs. The doctors noted uncertainty about whether the lung complication was caused by the Kawasaki disease itself, a reaction to the IVIG infusion known as transfusion-related acute lung injury (TRALI), or fluid overload from the transfusion (TACO). This research suggests that Kawasaki disease can occasionally lead to life-threatening complications involving multiple organ systems simultaneously, and that rapid, intensive medical treatment can lead to full recovery even in very serious cases. It also highlights a gap in medical knowledge about why some Kawasaki disease patients develop lung complications, and calls for further study to better understand the role that blood-product transfusions may play in triggering these events.
Xia X, Zhou J, Chen L, Zhang L. (2026). Kawasaki disease shock syndrome with pulmonary involvement in a child: a case report.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1930430