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A Teenager With Rash and Fever: Juvenile Systemic Lupus Erythematosus or Kawasaki Disease?
Rationale: Kawasaki disease (KD) is an acute vasculitis of small and medium vessels; whereas systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease. Their presentation is varied and not always straightforward, leading to misdiagnosis. There have been case reports of lupus onset...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154070/ https://www.ncbi.nlm.nih.gov/pubmed/32318531 http://dx.doi.org/10.3389/fped.2020.00149 |
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author | Saez-de-Ocariz, Marimar Pecero-Hidalgo, María José Rivas-Larrauri, Francisco García-Domínguez, Miguel Venegas-Montoya, Edna Garrido-García, Martín Yamazaki-Nakashimada, Marco Antonio |
author_facet | Saez-de-Ocariz, Marimar Pecero-Hidalgo, María José Rivas-Larrauri, Francisco García-Domínguez, Miguel Venegas-Montoya, Edna Garrido-García, Martín Yamazaki-Nakashimada, Marco Antonio |
author_sort | Saez-de-Ocariz, Marimar |
collection | PubMed |
description | Rationale: Kawasaki disease (KD) is an acute vasculitis of small and medium vessels; whereas systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease. Their presentation is varied and not always straightforward, leading to misdiagnosis. There have been case reports of lupus onset mimicking KD and KD presenting as lupus-like. Coexistence of both diseases is also possible. Patient concerns: We present three adolescents, one with fever, rash, arthritis, nephritis, lymphopenia, and coronary aneurysms, a second patient with rash, fever, aseptic meningitis, and seizures, and a third patient with fever, rash, and pleural effusion. Diagnoses: The first patient was finally diagnosed with SLE and KD, the second patient initially diagnosed as KD but eventually SLE and the third patient was diagnosed at onset as lupus but finally diagnosed as KD. Interventions: The first patient was treated with IVIG, corticosteroids, aspirin, coumadin and mycophenolate mofetil. The second patient was treated with IVIG, corticosteroids and methotrexate and the third patient with IVIG, aspirin and corticosteroids. Lessons: Both diseases may mimic each other's clinical presentation. KD in adolescence presents with atypical signs, incomplete presentation, and develop coronary complications more commonly. An adolescent with fever and rash should include KD and SLE in the differential diagnosis. |
format | Online Article Text |
id | pubmed-7154070 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-71540702020-04-21 A Teenager With Rash and Fever: Juvenile Systemic Lupus Erythematosus or Kawasaki Disease? Saez-de-Ocariz, Marimar Pecero-Hidalgo, María José Rivas-Larrauri, Francisco García-Domínguez, Miguel Venegas-Montoya, Edna Garrido-García, Martín Yamazaki-Nakashimada, Marco Antonio Front Pediatr Pediatrics Rationale: Kawasaki disease (KD) is an acute vasculitis of small and medium vessels; whereas systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease. Their presentation is varied and not always straightforward, leading to misdiagnosis. There have been case reports of lupus onset mimicking KD and KD presenting as lupus-like. Coexistence of both diseases is also possible. Patient concerns: We present three adolescents, one with fever, rash, arthritis, nephritis, lymphopenia, and coronary aneurysms, a second patient with rash, fever, aseptic meningitis, and seizures, and a third patient with fever, rash, and pleural effusion. Diagnoses: The first patient was finally diagnosed with SLE and KD, the second patient initially diagnosed as KD but eventually SLE and the third patient was diagnosed at onset as lupus but finally diagnosed as KD. Interventions: The first patient was treated with IVIG, corticosteroids, aspirin, coumadin and mycophenolate mofetil. The second patient was treated with IVIG, corticosteroids and methotrexate and the third patient with IVIG, aspirin and corticosteroids. Lessons: Both diseases may mimic each other's clinical presentation. KD in adolescence presents with atypical signs, incomplete presentation, and develop coronary complications more commonly. An adolescent with fever and rash should include KD and SLE in the differential diagnosis. Frontiers Media S.A. 2020-04-07 /pmc/articles/PMC7154070/ /pubmed/32318531 http://dx.doi.org/10.3389/fped.2020.00149 Text en Copyright © 2020 Saez-de-Ocariz, Pecero-Hidalgo, Rivas-Larrauri, García-Domínguez, Venegas-Montoya, Garrido-García and Yamazaki-Nakashimada. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Saez-de-Ocariz, Marimar Pecero-Hidalgo, María José Rivas-Larrauri, Francisco García-Domínguez, Miguel Venegas-Montoya, Edna Garrido-García, Martín Yamazaki-Nakashimada, Marco Antonio A Teenager With Rash and Fever: Juvenile Systemic Lupus Erythematosus or Kawasaki Disease? |
title | A Teenager With Rash and Fever: Juvenile Systemic Lupus Erythematosus or Kawasaki Disease? |
title_full | A Teenager With Rash and Fever: Juvenile Systemic Lupus Erythematosus or Kawasaki Disease? |
title_fullStr | A Teenager With Rash and Fever: Juvenile Systemic Lupus Erythematosus or Kawasaki Disease? |
title_full_unstemmed | A Teenager With Rash and Fever: Juvenile Systemic Lupus Erythematosus or Kawasaki Disease? |
title_short | A Teenager With Rash and Fever: Juvenile Systemic Lupus Erythematosus or Kawasaki Disease? |
title_sort | teenager with rash and fever: juvenile systemic lupus erythematosus or kawasaki disease? |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154070/ https://www.ncbi.nlm.nih.gov/pubmed/32318531 http://dx.doi.org/10.3389/fped.2020.00149 |
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