معرفی یک مورد نادر و آتیپیک واسکولیت کاوازاکی در بالغین

    Kawasaki is an acute multisystemic disease with high fever in infants. Kawasaki is an unknown vasculitis that involves small and moderate size arteries especially coronary vessels. Clinical manifestations of Kawasaki are nonspecific and consist of persistant fever for more than 5 days, maculopapular skin rash, mucosal inflamation, bilateral conjunctivitis, neck lymphadenopathy, erythema and desquamation of feet and hands. A 21-year-old woman was admitted with high fever, skin rash, conjunctivitis, fissure of lips, erythema and desquamation of feet, mucosal inflamation and neck lymphadenopathy which all had started 4 months ago. Laboratory examination showed anemia, CRP(C-Reactive Protein):3+, ESR (Erithroid Sedimant Rate):100-140mm/h but HIV(Human Immunodeficiency Virus), HBV(Hepatitis B Virus), HCV(Hepatitis C Virus), B/C (Blood/Culture), U/C(Urine/Culture), PPD(Purified Protein Degradative), wright, widal, anti ds DNA, ANA(Anti Nuclear Antibody), antitoxoplasmosis were negative. Echocardiography was normal. Imaging examination including spiral CT-scan of lungs, abdomen and pelvic were normal but sonography detected hypoecho mass compatible with submandibular adenopathy. Biopsy of neck adenopathy and skin lesion confirmed reactive adenitis and vasculitis respectively. Therefore, Kawasaki disease was confirmed by ruling out the possibility of other similar diseases. Although Kawasaki disease was often seen in infants, in adults with persistant fever, skin rash, adenopathy, bilateral conjunctivitis and mucosal inflamation, Kawasaki should be considered after ruling out other diseases.