Wolff Anne E, Hansen Karen E, Zakowski Laura
St. Louis University, St. Louis, Missouri, USA.
J Gen Intern Med. 2007 May;22(5):681-4. doi: 10.1007/s11606-006-0100-5.
Kawasaki Disease is a small-to-medium-vessel vasculitis that preferentially affects children. Kawasaki Disease can occur in adults, but the presentation may differ from that observed in children. Typical findings in both adults and children include fever, conjunctivitis, pharyngitis, and skin erythema progressing to a desquamating rash on the palms and soles. Adults more frequently present with cervical adenopathy (93% of adults vs. 15% of children), hepatitis (65% vs. 10%), and arthralgia (61% vs. 24-38%). In contrast, adults are less frequently affected by meningitis (10% vs. 34%), thrombocytosis (55% vs. 100%), and coronary artery aneurysms (5% vs. 18-25%). We report a case of acute Kawasaki Disease in a 24-year-old man who presented with rash, fever, and arthritis. He was successfully treated with high-dose aspirin and intravenous immunoglobulin (IVIG). Our case highlights the importance of considering Kawasaki Disease in adults presenting with symptoms commonly encountered in a general medical practice.
川崎病是一种主要累及儿童的中小血管血管炎。川崎病也可发生于成人，但其临床表现可能与儿童不同。成人和儿童的典型表现均包括发热、结膜炎、咽炎以及进展为手掌和足底脱皮性皮疹的皮肤红斑。成人更常出现颈部淋巴结病（成人中占93%，儿童中占15%）、肝炎（65%对10%）和关节痛（61%对24 - 38%）。相比之下，成人患脑膜炎（10%对34%）、血小板增多症（55%对100%）和冠状动脉瘤（5%对18 - 25%）的情况较少。我们报告一例24岁男性急性川崎病病例，该患者表现为皮疹、发热和关节炎。他通过大剂量阿司匹林和静脉注射免疫球蛋白（IVIG）成功治愈。我们的病例强调了在出现普通医疗实践中常见症状的成人中考虑川崎病的重要性。
