Atypical Kawasaki Disease in an Adolescent with Multivisceral Involvement

Haddar, Zohair El; Ouali, Aziza El; Ghanam, Ayad; Rkain, Maria; Benajiba, Noufissa; Babakhouya, Abdeladim

doi:10.1155/2021/8941847

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…Another 18 cases were documented in other case reports. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Among the 136 reported cases, including ours, the oldest patient was 17 years old, 27,32 suggesting that KD can affect patients of any age because adult-onset KD in patients from 18 to 68 years of age has also been previously identified. KD in adolescents is more likely to affect male patients.…”

Section: Discussionmentioning

confidence: 93%

“…A new syndrome known as multisystem inflammatory syndrome in children (MIS-C), characterized by a systemic inflammatory status that seems to be related to SARS-CoV-2 infection, was recently identified. 33 , 38 , 39 It is essential to distinguish adolescent-onset KD from MIS-C during the COVID-19 pandemic because several common symptoms are common to both KD and MIS-C, and MIS-C predominantly affects older children. 40 Moreover, the prognosis of MIS-C is worse than that of KD.…”

Section: Discussionmentioning

confidence: 99%

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Clinical characteristics of Kawasaki disease in adolescents

et al. 2021

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Objective Studies focusing on Kawasaki disease (KD) in adolescents are lacking in Southwest China. We systematically summarized the clinical characteristics of KD in adolescents to improve pediatricians’ recognition of this condition. Methods The clinical data of patients with adolescent-onset KD in our center were retrospectively analyzed. The patients were divided into Group A (n = 7), whose first hospitalization was at our hospital, and Group B (n = 10), who were transferred from their local hospital or community health center. Results Seventeen patients with adolescent-onset KD were identified (constituent ratio of 0.8%). Seven patients had an intermittent fever for >10 days. The incidence of incomplete KD was 52.9%. These patients had a high incidence of other atypical clinical manifestations. Fifteen patients were initially misdiagnosed with other infectious diseases. Although the incidence of typical KD was higher in Group B, the overall misdiagnosis rate at the initial stages was higher and the average fever duration on arrival and before IVIG administration were much longer in Group B than A. Conclusions KD in adolescents was frequently misdiagnosed, which might be associated with its atypical, diverse clinical features and pediatricians’ poor recognition. Pediatricians must be aware of the possibility of KD in adolescents.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of Kawasaki disease in adolescents

et al. 2021

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Kawasaki disease in Kenya and review of the African literature

Migowa,

Njeru,

Were

et al. 2024

Pediatr Rheumatol

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Background Kawasaki disease has been described across the globe, although publications from Africa are limited. To our knowledge, there are no publications on Kawasaki disease from Kenya, which triggered this report. Methods A retrospective cross-sectional study was undertaken to identify in-patients with a discharge diagnosis of Kawasaki disease, over 2 different 5-year periods, at two pediatric hospitals in Nairobi, Kenya. We reviewed the medical records of all patients and report their clinical findings, diagnostic workup and treatment. In addition, we undertook a detailed review of the literature. Results Twenty-three patients with Kawasaki disease were identified, of those 12 (52.2%) had incomplete disease. The mean age was 2.3 years (SD+/-2.2) (range 0.3–10.3) with a male to female ratio of 1:1. The mean duration of fever at diagnosis was 8.3 days (SD+/-4.7) (range 2–20). Oral changes were the most common clinical feature and conjunctivitis the least common. Thrombocytosis at diagnosis was seen in 52% (12/23). Twenty-one patients (91.3%) were treated with intravenous immunoglobulin and all except 1 received aspirin. Baseline echocardiograms were performed in 95.7% (22/23) and found to be abnormal in 3 (13.6%). Follow-up data was limited. Our literature review identified 79 publications with documented cases of Kawasaki disease in children from 22 countries across the African continent with a total of 1115 patients including those from this report. Only 153 reported cases, or 13.7%, are from sub-Saharan Africa. Conclusions This is the first publication on Kawasaki disease from Kenya and one of the largest reports from sub-Saharan Africa. It is the first to have a complete review of the number of published cases from the African continent. Challenges in the diagnosis and management of Kawasaki disease in many African countries include disease awareness, infectious confounders, access and cost of intravenous immunoglobulin, access to pediatric echocardiography and follow-up. Increasing awareness and health care resources are important for improving outcomes of Kawasaki disease in Africa.

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Atypical Kawasaki Disease in an Adolescent with Multivisceral Involvement

Cited by 2 publications

References 20 publications

Clinical characteristics of Kawasaki disease in adolescents

Clinical characteristics of Kawasaki disease in adolescents

Kawasaki disease in Kenya and review of the African literature

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