Two Distinct Cases of Adult-onset Kawasaki Disease

Intern Med. 2022 Dec 1;61(23):3525-3529. doi: 10.2169/internalmedicine.9044-21. Epub 2022 Apr 23.

Abstract

Kawasaki disease (KD) is a systemic vasculitis syndrome that mostly affects children under 4 years old. Among the reported KD cases, only 1% were over 10 years old. We herein report 2 cases of adult-onset KD (AKD) in 19- and 17-year-old boys diagnosed with a persistent fever and cervical lymphadenitis. Both patients showed cardiac complications, such as coronary artery dilation and myocarditis. Repeated intravenous immunoglobulin therapy was effective in the 19-year-old, while plasma exchange therapy was needed for the 17-year-old, with no sequelae noted at discharge. KD should be considered as a differential diagnosis for persistent fever in adults.

Keywords: adult-onset Kawasaki disease; coronary artery lesion; lymphadenitis; myocarditis; persistent fever.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Coronary Aneurysm* / complications
  • Coronary Vessels
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Lymphadenitis* / complications
  • Male
  • Mucocutaneous Lymph Node Syndrome* / complications
  • Mucocutaneous Lymph Node Syndrome* / diagnosis
  • Mucocutaneous Lymph Node Syndrome* / therapy
  • Young Adult

Substances

  • Immunoglobulins, Intravenous