BACKGROUND: Kawasaki-like syndrome (KLS) is rare in adults; one third of these patients are infected by Human immunodeficiency virus (HIV). Our study reports cases of KLS occurring in HIV-positive adults and reviews the literature to compare their characteristics with HIV-negative adults and children with Kawasaki disease (KD). METHODS: Report of cases and review of the literature. RESULTS: Amongst 20 cases reviewed, including 4 who were managed at our institution, KLS was associated with severe immunosuppression and a high HIV viral load. There was frequent co-infection by hepatitis viruses. Desquamation and liver abnormalities were more frequent in HIV-negative adults whereas headaches and gastrointestinal disorders more common in HIV-positive adults. Intravenous immunoglobulin was effective therapy. Relapse was more frequent among HIV-positive patients. No cardiovascular complications or deaths occurred. CONCLUSIONS: Advanced immunosuppression due to HIV may predispose to KLS. The differential diagnosis that must be considered includes drug hypersensitivity reactions and staphylococcal infections.
BACKGROUND:Kawasaki-like syndrome (KLS) is rare in adults; one third of these patients are infected by Human immunodeficiency virus (HIV). Our study reports cases of KLS occurring in HIV-positive adults and reviews the literature to compare their characteristics with HIV-negative adults and children with Kawasaki disease (KD). METHODS: Report of cases and review of the literature. RESULTS: Amongst 20 cases reviewed, including 4 who were managed at our institution, KLS was associated with severe immunosuppression and a high HIV viral load. There was frequent co-infection by hepatitis viruses. Desquamation and liver abnormalities were more frequent in HIV-negative adults whereas headaches and gastrointestinal disorders more common in HIV-positive adults. Intravenous immunoglobulin was effective therapy. Relapse was more frequent among HIV-positive patients. No cardiovascular complications or deaths occurred. CONCLUSIONS: Advanced immunosuppression due to HIV may predispose to KLS. The differential diagnosis that must be considered includes drug hypersensitivity reactions and staphylococcal infections.
Authors: Jan Marc Orenstein; Stanford T Shulman; Linda M Fox; Susan C Baker; Masato Takahashi; Tricia R Bhatti; Pierre A Russo; Gary W Mierau; Jean Pierre de Chadarévian; Elizabeth J Perlman; Cynthia Trevenen; Alexandre T Rotta; Mitra B Kalelkar; Anne H Rowley Journal: PLoS One Date: 2012-06-18 Impact factor: 3.240
Authors: Francisco Rivas-Larrauri; Lorena Aguilar-Zanela; Paola Castro-Oteo; Luis Adrian Rosales-Hernandez; Francisco Otero-Mendoza; Gabriela López-Herrera; Javier Ordoñez-Ortega; Martín Garrido-García; Marco Antonio Yamazaki-Nakashimada Journal: Rheumatol Int Date: 2019-07-16 Impact factor: 3.580
Authors: Anne H Rowley; Susan C Baker; Stanford T Shulman; Francesca L Garcia; Linda M Fox; Ian M Kos; Susan E Crawford; Pierre A Russo; Rashid Hammadeh; Kei Takahashi; Jan M Orenstein Journal: PLoS One Date: 2008-02-13 Impact factor: 3.240