Advertisement

Rare case of pulmonary involvement in an adult with Kawasaki disease

      Highlights

      • Kawasaki disease (KD) is an acute, self-limited, febrile vasculitis typically seen in early childhood.
      • Pulmonary involvement is uncommon and is not part of the conventional diagnostic criteria.
      • Pulmonary opacities in KD are thought to represent a host response to the causative agent and resolve as patients recover.
      • Timely diagnosis of KD is vital in prevention of coronary artery aneurysms and potentially life-threatening consequences.

      Abstract

      Kawasaki disease is an acute, self-limited, febrile vasculitis typically seen in early childhood. Pulmonary involvement is uncommon and is not part of the conventional diagnostic criteria. We add to the literature a unique case of a 22 year-old male with Kawasaki disease and pulmonary involvement. It illustrates the importance of recognizing unusual presentations of Kawasaki disease and highlights the possibility of pulmonary abnormalities on physical and imaging examination. Awareness of such presentations can help avoid delayed diagnosis, prevent the development of coronary aneurysms, and allow careful observation for imaging resolution.

      Abbreviations:

      CT (computed tomography)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • BW McCrindle
        • Rowley A.H.
        • Newburger J.W.
        • Burns J.C.
        • Bolger A.F.
        • Gewitz M.
        • et al.
        Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Council on Epidemiology and Prevention.
        Circulation. 2017; 135: e927-e999
        • Garty B.
        • Mosseri R.
        • Finkelstein Y.
        Guttate psoriasis following Kawasaki disease.
        Pediatr Dermatol. 2001; 18: 507-508
        • Ivory D.
        • Folzenlogen D.
        Post streptococcal syndromes, a rheumatologist perspective.
        Int J Rheum Dis. 2009; 6
        • Umezawa T.
        • Saji T.
        • Matsuo N.
        • Odagiri K.
        Chest X-ray findings in the acute phase of Kawasaki disease.
        Pediatr Radiol. 1989; 20: 48-51
        • Freeman A.F.
        • Crawford S.E.
        • Finn L.S.
        • López-Andreu J.A.
        • Ferrando-Monleón S.
        • Pérez-Tamarit D.
        • et al.
        Inflammatory pulmonary nodules in Kawasaki disease.
        Pediatr Pulmonol. 2003; 36: 102-106
        • Kim J.Y.
        • Kwon J.H.
        • Kim K.H.
        • Yu J.H.
        • Hong Y.M.
        Chest X-ray findings and serum tumor necrosis factor-α levels in patients with Kawasaki disease.
        Korean J Pediatr. 2005; 48: 534-538
        • Monedero Picazo M.D.
        • Gómez Fernández-Montes J.
        • Molina Fábrega R.
        • Vallcanera Calatayud A.
        • Alabau Vázquez G.
        • et al.
        Radiologic findings in the lungs of patients with Kawasaki disease.
        Radiologia. 2006; 48: 14-18
        • Uziel Y.
        • Hashkes P.J.
        • Kassem E.
        • Gottesman G.
        • Wolach B.
        “Unresolving pneumonia” as the main manifestation of atypical Kawasaki disease.
        Arch Dis Child. 2003; 88: 940-942
        • Ugi J.
        • Lepper P.M.
        • Witschi M.
        • Maier V.
        • Geiser T.
        • Ott S.R.
        Nonresolving pneumonia and rash in an adult: pulmonary involvements in Kawasaki's disease.
        Eur Respir J. 2010; 35: 452-454