Acute Febrile Cholestatic Jaundice in Children: Keep in Mind Kawasaki Disease

Kawasaki disease (KD) is characterized by persistent fever in addition to four of five signs of mucocutaneous inflammation. Although gastrointestinal involvement does not belong to the classic diagnostic criteria, it has been often associated with KD onset. We reviewed all those patients who were admitted for febrile cholestatic jaundice between 2003 and 2010 in two tertiary pediatric care centres. We found that KD was the second most frequent cause (21%) after viral infections. We also briefly described the clinical presentation of those patients affected by KD and presented with acute febrile jaundice. Considering the relative high frequency of this condition a high index of suspicion of KD should be maintained in patients presenting with febrile cholestatic jaundice.