Adult Kawasaki Syndrome

Butler, David F.; Hough, Douglas R.; Friedman, Stephen J.; Davis, Harry E.

doi:10.1001/archderm.1987.01660340118032

Cited by 34 publications

(7 citation statements)

References 29 publications

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“…However, platelet counts in these patients were still within the accepted "normal" range, and therefore, reliable cut-off levels for differential diagnosis between KDSS and TSS could not be defined. 32,33 The absence of a clear diagnostic criterion based on platelet count is corroborated by previous studies, which have reported an inconsistent association between thrombocytosis or thrombocytopenia and KDSS. As an example, although Kanegaye et al 6 reported significantly lower platelet counts in 13 patients with KDSS (148 × 10 3 per μL) compared with patients with KD without shock (410 × 10 3 per μL), 4 patients in their study group had a normal platelet count before IVIG therapy, and the level for 2 other patients were not reported.…”

Section: Discussionsupporting

confidence: 55%

“…[19][20][21][22][23][24][25] Therefore, we conducted a retrospective medical chart review to compare and contrast the clinical features of patients with KDSS and TSS, with the aim of identifying specific features that would inform early differential diagnosis between these 2 conditions.…”

Section: Discussionmentioning

confidence: 99%

“…However, KDSS has been described in patients over the entire age range of pediatrics, 3 and even in adult patients. 19,[26][27][28] Therefore, age does not provide a specific criterion for the differential diagnosis of KDSS from TSS, and consequently, other clinical features or parameters are required to reliably differentiate these 2 conditions.…”

Section: Discussionmentioning

confidence: 99%

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Early Differentiation of Kawasaki Disease Shock Syndrome and Toxic Shock Syndrome in a Pediatric Intensive Care Unit

Lin

Cheng

et al. 2015

Pediatric Infectious Disease Journal

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Early Differentiation of Kawasaki Disease Shock Syndrome and Toxic Shock Syndrome in a Pediatric Intensive Care Unit

Lin

Cheng

et al. 2015

Pediatric Infectious Disease Journal

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“…Patients with no evidence of aneurysm or ectasia at the 1-year evaluation are not likely to benefit from further repeated echocardiography, although patients with transient coronary artery ectasia early in the illness may be followed up at 3-to 5-year intervals. 19,20 Magnetic resonance imaging can also assess coronary morphology with low temporal resolution (20-50 ms). The 3-dimensional spatial resolution achievable is marginal for coronary arterial imaging and is not as reliable as multidetector computed tomography.…”

Section: Discussionmentioning

confidence: 99%

Adult Kawasaki's disease with myocarditis, splenomegaly, and highly elevated serum ferritin levels

et al. 2010

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Kawasaki's disease is a disease of unknown cause. The characteristic clinical features of Kawasaki's disease are fever> or =102 degrees F for> or =5 days accompanied by a bilateral bulbar conjunctivitis/conjunctival suffusion, erythematous rash, cervical adenopathy, pharyngeal erythema, and swelling of the dorsum of the hands/feet. Kawasaki's disease primarily affects children and is rare in adults. In children, Kawasaki's disease is more likely to be associated with aseptic meningitis, coronary artery aneurysms, and thrombocytosis. In adult Kawasaki's disease, unilateral cervical adenopathy, arthritis, conjunctival suffusion/conjunctivitis, and elevated serum transaminases (serum glutamic oxaloacetic transaminase [SGOT]/serum glutamate pyruvate transaminase [SGPT]) are more likely. Kawasaki's disease in adults may be mimicked by other acute infections with fever and rash, that is, group A streptococcal scarlet fever, toxic shock syndrome (TSS), and Rocky Mountain Spotted Fever (RMSF). Because there are no specific tests for Kawasaki's disease, diagnosis is based on clinical criteria and the syndromic approach. In addition to rash and fever, scarlet fever is characterized by circumoral pallor, oropharyngeal edema, Pastia's lines, and peripheral eosinophilia, but not conjunctival suffusion, splenomegaly, swelling of the dorsum of the hands/feet, thrombocytosis, or an elevated SGOT/SGPT. In TSS, in addition to rash and fever, there is conjunctival suffusion, oropharyngeal erythema, and edema of the dorsum of the hands/feet, an elevated SGOT/SGPT, and thrombocytopenia. Patients with TSS do not have cervical adenopathy or splenomegaly. RMSF presents with fever and a maculopapular rash that becomes petechial, first appearing on the wrists/ankles after 3 to 5 days. RMSF is accompanied by a prominent headache, periorbital edema, conjunctival suffusion, splenomegaly, thrombocytopenia, an elevated SGOT/SGPT, swelling of the dorsum of the hands/feet, but not oropharyngeal erythema. We present a case of adult Kawasaki's disease with myocarditis and splenomegaly. The patient's myocarditis rapidly resolved, and he did not develop coronary artery aneurysms. In addition to splenomegaly, this case of adult Kawasaki's disease is remarkable because the patient had highly elevated serum ferritin levels of 944-1303 ng/mL; (normal<189 ng/mL). To the best of our knowledge, this is the first report of adult Kawasaki's disease with highly elevated serum ferritin levels. This is also the first report of splenomegaly in adult Kawasaki's disease. We conclude that Kawasaki's disease should be considered in the differential diagnosis in adult patients with rash/fever for> or =5 days with conjunctival suffusion, cervical adenopathy, swelling of the dorsum of the hands/feet, thrombocytosis and otherwise unexplained highly elevated ferritin levels.

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“…The disease is most commonly seen in children younger than 5 years of age and is distinctly uncommon after adolescence. 1 There is no diagnostic laboratory test for KD. However, elevated platelet counts are a consistent feature of this particular illness.…”

mentioning

confidence: 99%

Severe Thrombocytopenia as a Presenting Manifestation of Kawasaki Disease

Venglarcik¹

1995

Arch Pediatr Adolesc Med

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Adult Kawasaki Syndrome

Cited by 34 publications

References 29 publications

Early Differentiation of Kawasaki Disease Shock Syndrome and Toxic Shock Syndrome in a Pediatric Intensive Care Unit

Early Differentiation of Kawasaki Disease Shock Syndrome and Toxic Shock Syndrome in a Pediatric Intensive Care Unit

Adult Kawasaki's disease with myocarditis, splenomegaly, and highly elevated serum ferritin levels

Severe Thrombocytopenia as a Presenting Manifestation of Kawasaki Disease

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