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Emergency: requires immediate attention
Kawasaki disease in Adult
See also in: External and Internal Eye,Anogenital,Oral Mucosal Lesion
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Other Resources UpToDate PubMed
Emergency: requires immediate attention

Kawasaki disease in Adult

See also in: External and Internal Eye,Anogenital,Oral Mucosal Lesion
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Contributors: Tyler Werbel, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Kawasaki disease (KD), or mucocutaneous lymph node syndrome, is a multisystem vasculitis that primarily affects infants and children. The exact cause is unknown, although several clinical and epidemiologic features of the disease suggest an infectious, likely viral, etiology that evokes an abnormal immunologic response in genetically susceptible individuals. The disease occurs primarily in children younger than 6 years, and in most cases, it occurs in individuals who live in East Asia or are of Asian ancestry. It is classically characterized by fever lasting at least 5 days (usually longer) plus 4 of the 5 following criteria:
  • Bilateral bulbar conjunctival injection without exudate
  • Oral mucosa changes: cracked lips, "strawberry tongue," or diffuse erythema of the mucosae
  • Changes in the extremities: erythema, induration, or periungual peeling
  • Exanthem
  • Cervical lymphadenopathy (greater than 1.5 cm diameter)
Most individuals affected by KD follow a benign disease course. However, coronary artery aneurysms develop in 20%-25% of untreated patients. Treatment is aimed at decreasing the risk of developing coronary artery abnormalities and preventing complications from these abnormalities.

Adult Patient Considerations:
KD can uncommonly occur in adults. The diagnostic criteria used for pediatric patients have not yet been validated in adults, but using these criteria, both complete and incomplete forms occur in adults. It is associated with HIV infection in up to one-fifth of cases. Lymphadenopathy and joint involvement occur with a higher frequency in adults with KD than children, and cheilitis is less frequent. Cardiac complications may occur in adults including aneurysm formation; other reported cardiac complications include valvular abnormalities and heart failure. Treatment is usually delayed in adults, given delay in diagnosis, but is similar to that in children.

For more information, see OMIM.

Codes

ICD10CM:
M30.3 – Mucocutaneous lymph node syndrome [Kawasaki]

SNOMEDCT:
75053002 – Kawasaki disease

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

In adult patients, consider adult-onset Still disease.

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 08/09/2018
Last Updated: 03/06/2019
Copyright © 2019 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Kawasaki disease in Adult
See also in: External and Internal Eye,Anogenital,Oral Mucosal Lesion
Print 1 Images
Kawasaki disease : Abdominal pain, Cervical lymphadenopathy, Diarrhea, Fever, Vomiting, Rash, Hand edema, Heart murmur, Irritability, Conjunctival injection, Strawberry tongue
Clinical image of Kawasaki disease
Copyright © 2019 VisualDx®. All rights reserved.