Two Distinct Cases of Adult-onset Kawasaki Disease

• Published in: Internal Medicine Vol. 61; no. 23; pp. 3525 - 3529
• Main Authors: Onoki, Takehiko, Metoki, Takaya, Iwasawa, Shinya, Kawano, Kengo, Kimura, Masato, Kure, Shigeo, Ota, Chiharu
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-12-2022; Japan Science and Technology Agency
• Subjects: Adolescent; Adult; adult-onset Kawasaki disease; Case Report; Child; Child, Preschool; Complications; Coronary Aneurysm - complications; Coronary artery; coronary artery lesion; Coronary Vessels; Differential diagnosis; Fever; Humans; Immunoglobulins, Intravenous - therapeutic use; Internal medicine; Intravenous administration; Lymphadenitis; Lymphadenitis - complications; Male; Mucocutaneous lymph node syndrome; Mucocutaneous Lymph Node Syndrome - complications; Mucocutaneous Lymph Node Syndrome - diagnosis; Mucocutaneous Lymph Node Syndrome - therapy; Myocarditis; persistent fever; Systemic vasculitis; Young Adult; adult-onset Kawasaki disease; persistent fever; myocarditis; coronary artery lesion; lymphadenitis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.9044-21

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.