Adult-onset Kawasaki disease (mucocutaneous lymph node syndrome) and concurrent Coxsackievirus A4 infection: a case report

Kawasaki disease (KD) or Mucocutaneous Lymph node Syndrome is a systemic vasculitis, which mainly affects children under five years of age with Asian descent, but can also reach other age groups, as well as any other breed. The clinical picture of KD has three stages: acute febrile stage, in which conjunctival congestion, oral mucositis, erythema, flaking, polymorphic rash and laterocervical lymphadenopathy, appear as main symptoms; the subacute stage, which occurs at the end of fever, and leads to the appearance of skin flaking in the limbs, arthritis, arthralgia and thrombocytosis and finally the stage of convalescence that arises when symptoms are almost dissipating and continues until their normalization. The most used treatment occurs from the administration of intravenous immunoglobulin, which for better prognosis of the pathology should be initiated early.

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HLA Antigens in Mucocutaneous Lymph Node Syndrome in New England

PEDIATRICS ◽

10.1542/peds.67.5.741 ◽

1981 ◽

Vol 67 (5) ◽

pp. 741-743

Author(s):

Alan M. Krensky ◽

William Berenberg ◽

Karen Shanley ◽

Edmond J. Yunis

Keyword(s):

Lymph Node ◽

Kawasaki Disease ◽

New England ◽

Ethnic Groups ◽

Genetic Predisposition ◽

Hla Antigens ◽

Immune Responsiveness ◽

Mucocutaneous Lymph Node Syndrome ◽

Japanese Studies ◽

Lymph Node Syndrome

HLA antigens were evaluated in 27 patients with mucocutaneous lymph node symdrome (Kawasaki disease) in the Boston area. In contrast to previous Japanese studies, no incidence of HLA-Bw22 was found. A significant increase (P .002), however, in HLA-Bw51 was found in the patients with mucocutaneous lymph node syndrome as compared to an appropriate control population. To our knowledge, this is only the second disease associated with HLA-B5 specificity. The observations illustrate the lack of unified genetic predisposition for a disease in two ethnic groups, white and Japanese. Such findings may have genetic implications regarding interhuman variation in immune responsiveness.

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Case Reports Are Valuable

PEDIATRICS ◽

10.1542/peds.60.5.762 ◽

1977 ◽

Vol 60 (5) ◽

pp. 762-762

Author(s):

Edward B. Shaw

Keyword(s):

United States ◽

Medical Journal ◽

Case Report ◽

Lymph Node ◽

Mass Production ◽

Single Case ◽

Case Reports ◽

Mucocutaneous Lymph Node Syndrome ◽

Lymph Node Syndrome

The excellent case report "Mucocutaneous Lymph Node Syndrome (MLNS) in the Continental United States" by Goldsmith et al. (Pediatrics 57:431, March 1976) is an example of the importance of the report of a single case. This should alert others to this syndrome in their own practices. I am reminded of a note by Roger Lee1 in 1952: "Are three cases enough to make a series? Parenthetically I have a fondness for the carefully reported single case, which in the days before mass production was a feature of a medical journal .... a series of three cases leads to statistical atrocities and aberrations and deductions."

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