Reviewer’s report
Title: 
ACUTE CHOLESTASIS AS UNCOMMON ONSET OF KAWASAKI
DISEASE: CASE REPORT
Version: 
1 
Date: 
19 Dec 2019
Reviewer's report:
The English language is a bit strange, I even understood with difficulty some
terms after referring to the dictionary. I will include some of my comments on
the language:
Phlogosis for inflammatory Dictionary: inflammation of the external parts of the
body
elevated phlogosis exams: do they mean acute phase reactants, namely ESR and
CRP?
Epiploon: omentum
Coproculture: is it stool culture?
What 
is: "intravenous antiinflammatory therapy"?
Instead, when laparotomy exploration is performed, it reveals a calculous,
inflamed and edematous gallbladder? What do the authors mean? a calculous or
acalculous?
Are the authors sure of the diagnosis of Kawasaki disease? The patient has been
sick for weeks without any involvement of medium sized vessels: coronory,
axillary, subclavian, popliteal, femoral, brachial
Severe forms of KD include: KD shock syndrome: from myocardial involvement
and are the most liable to coronary artery involvement and DIC with
thrombocytopenia
Multiplicity of lymph nodes, not unilateral >1.5 cm
Why is not the case drug-reaction? particularly that the authors chose first-line
treatment: steroids? Not IVIG? In the literature the Japanese have used steroids
to improve coronary outcome according to Japanese literature and Kobayashi
score (combined steroids and IVIG)
The authors mentioned the following:Corticosteroid treatment should be given to
patients with severe KD, who are intravenous immunoglobulins resistant. Have
they used IVIG and proved resistant?
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Unable to assess
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively edited
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title: 
ACUTE CHOLESTASIS AS UNCOMMON ONSET OF KAWASAKI
DISEASE: CASE REPORT
Version: 
1 
Date: 
19 Dec 2019
Reviewer's report:
The English language is a bit strange, I even understood with difficulty some
terms after referring to the dictionary. I will include some of my comments on
the language:
Phlogosis for inflammatory Dictionary: inflammation of the external parts of the
body
elevated phlogosis exams: do they mean acute phase reactants, namely ESR and
CRP?
Epiploon: omentum
Coproculture: is it stool culture?
What 
is: "intravenous antiinflammatory therapy"?
Instead, when laparotomy exploration is performed, it reveals a calculous,
inflamed and edematous gallbladder? What do the authors mean? a calculous or
acalculous?
Are the authors sure of the diagnosis of Kawasaki disease? The patient has been
sick for weeks without any involvement of medium sized vessels: coronory,
axillary, subclavian, popliteal, femoral, brachial
Severe forms of KD include: KD shock syndrome: from myocardial involvement
and are the most liable to coronary artery involvement and DIC with
thrombocytopenia
Multiplicity of lymph nodes, not unilateral >1.5 cm
Why is not the case drug-reaction? particularly that the authors chose first-line
treatment: steroids? Not IVIG? In the literature the Japanese have used steroids
to improve coronary outcome according to Japanese literature and Kobayashi
score (combined steroids and IVIG)
The authors mentioned the following:Corticosteroid treatment should be given to
patients with severe KD, who are intravenous immunoglobulins resistant. Have
they used IVIG and proved resistant?
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Unable to assess
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively edited
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title: 
ACUTE CHOLESTASIS AS UNCOMMON ONSET OF KAWASAKI
DISEASE: CASE REPORT
Version: 
1 
Date: 
19 Dec 2019
Reviewer's report:
The English language is a bit strange, I even understood with difficulty some
terms after referring to the dictionary. I will include some of my comments on
the language:
Phlogosis for inflammatory Dictionary: inflammation of the external parts of the
body
elevated phlogosis exams: do they mean acute phase reactants, namely ESR and
CRP?
Epiploon: omentum
Coproculture: is it stool culture?
What 
is: "intravenous antiinflammatory therapy"?
Instead, when laparotomy exploration is performed, it reveals a calculous,
inflamed and edematous gallbladder? What do the authors mean? a calculous or
acalculous?
Are the authors sure of the diagnosis of Kawasaki disease? The patient has been
sick for weeks without any involvement of medium sized vessels: coronory,
axillary, subclavian, popliteal, femoral, brachial
Severe forms of KD include: KD shock syndrome: from myocardial involvement
and are the most liable to coronary artery involvement and DIC with
thrombocytopenia
Multiplicity of lymph nodes, not unilateral >1.5 cm
Why is not the case drug-reaction? particularly that the authors chose first-line
treatment: steroids? Not IVIG? In the literature the Japanese have used steroids
to improve coronary outcome according to Japanese literature and Kobayashi
score (combined steroids and IVIG)
The authors mentioned the following:Corticosteroid treatment should be given to
patients with severe KD, who are intravenous immunoglobulins resistant. Have
they used IVIG and proved resistant?
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Unable to assess
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Unable to assess
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively edited
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal
assistant