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• W2978551603 abstract "Introduction: Kawasaki disease (KD) is a common vasculitis in children, but adult onset is rare. Gastrointestinal manifestations are reported, but with few reports of clinical pancreatitis. We report a case of acute pancreatitis in a young adult with KD. A previously healthy 19-year-old male presented with a 2-week history of fevers, chills, a diffuse maculopapular rash including his palms and soles, non-exudative bilateral scleral injection, a papular and erythematous tongue with fissured lips, and an unintentional 10-lb weight loss. Five days prior to presentation, symptoms progressed to severe epigastric pain, nausea, and vomiting, prompting evaluation. At presentation, labs were significant for a lipase of 1031 U/L and CT imaging showed acute pancreatitis with no necrosis or abscess. He was treated with bowel rest, pain control, and fluid hydration with clinical improvement by hospital day 3 and transition to a regular diet. Work-up revealed no evidence of gallstones, biliary dilation, or pancreatic mass seen on CT. Ethanol and triglyceride levels were unremarkable, and he denied recent trauma or illicit drug use. Throughout hospitalization, he continued to have fevers to 102.8F. An infectious work-up was negative to include HIV, influenza, lyme, CMV, EBV, coxsackie, hepatitis, HSV, and mycoplasma. A chest CT and echocardiogram were also negative. He clinically improved and was subsequently discharged. However, 5 days later, he re-presented with a desquamating palmar and plantar rash, persistent fever, conjunctivitis, chest pain, and inability to walk due to severe arthritis in the ankles and knees. A repeat echocardiogram showed cardiac ectasia concerning for a diagnosis of KD. He was started on IVIG and high-dose aspirin with symptomatic improvement within 72 hours. KD is a necrotizing vasculitis of mediumsized arteries and primarily affects children with an annual incidence of 0.26/100,000 between ages 15-20 years. Typical symptoms include fever, scleral injection, rash on the palms and soles, cervical lymphadenopathy, and mucosal injection. Gastrointestinal symptoms may include diarrhea, intrahepatic bile duct inflammation and stenosis, hepatitis, and hydrops of the gallbladder. Pancreatitis is a rare complication from KD, and is likely a result of a vasculitis of the pancreatic vasculature or from hypertriglyceridemia, a common manifestation in KD. Autopsy reports indicating a histologic diagnosis of pancreatitis is common, but clinical pancreatitis is very rare. Our case is unique because our patient was an adult with KD complicated by clinical pancreatitis. Although rare, KD should be considered, as it can be successfully treated with IVIG to prevent cardiac complications." @default.
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• W2978551603 date "2014-10-01" @default.
• W2978551603 modified "2023-09-25" @default.
• W2978551603 title "Kawasaki Disease Complicated by Pancreatitis in an Adult" @default.
• W2978551603 doi "https://doi.org/10.14309/00000434-201410002-00963" @default.
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