lip sweling kawasaki

CASE REPORT Recurrent lip swelling as a late presentation of Kawasaki disease: Case report and review of literature q Asmaa Faden * Department of Oral Medicine and Diagnostic Sciences, King Saud University, College of Dentistry, P.O. Box 60169, Riyadh 11545, Saudi Arabia Received 22 July 2012; accepted 3 October 2012 Available online 27 October 2012 KEYWORDS Kawasaki disease; Oral manifestati on; Recurrence; Lip swelling; Vasculitis; IVIG Abstract Kawas aki Disease (KD) is an acute syst emic vasculit is of unknown etiolo gy. In many developed countries, KD has replaced rheumatic heart disease as the leading cause of acquired heart disease in children. Among the classical criteria for a diagnosis of KD are oral manifestations such as strawberry tongue, erythematous cracked lip, and oropharyngeal mucositis. We report the case of a 24-year-old Saudi female with a history of Kawasaki disease who presented to our oral medicine clinic with recurrent painless swelling of the upper lip. As lip swelling has not previously been reported as an oral manifestation of KD, this case represents a novel presentation of recurrent Kawasaki disease in an adult female. ª 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved. 1. Introduction Kawasaki Disease (KD) was named after the Japanese pedia- trician Tomisaku Kawasaki, who in 1967 described 50 cases in which a rash and fever in early childhood were accompanied by edema, conjunctival infection, redness and cracking of the lips , ‘‘st rawberry tong ue,’ ’ conva lesc ent desquamat ion, and occasionally lymphadenopath y (Kawa saki , 1967; Kawasa ki et al., 1974). Also known as Muco cutaneous Lymph Node Syndrome , KD is an idiopathic infantile multi-organ vasculitis of medium and small-sized arteries. It typically affects children of Asian ethnicity younger than 4 years of age, although it may also oc- cur in adults, where it is often misdiagnosed due to its nonspe- ciﬁc clinical presentation ( Kanno et al., 2011; Se ` ve et al., 2005). KD occurs more often in boys than in girls (1.5:1 male:female ratio) (Cox and Sallis, 2009; Pemberton et al., 1999), and is considered to be the most common cause of acquired pediatric cardiac disease in developed countries ( Bhatnagar et al., 2003). Kawasaki disease has three phases. Most signs and symp- toms appear during the initial acute febrile phase, which lasts from 1 to 2 weeks. This is followed by a subacute phase, char- acterized by desquamat ion, arthralg ia, and elev ated plate let counts. This phase lasts from the end of the fever until approx- imat ely day 25. Fina lly, during the conva lesc ent phas e, the cli nic al si gns dis appear and acute- pha se rea ctants such as erythrocyte sedimentation rate (ESR) return to normal. The average duration of Kawasaki disease is 6–8 weeks. * Tel.: +966 555022421. E-mail address: [email protected]. q The manus cr ipt was pre sen ted as a Pos ter in the Ame ri can Aca demy of Ora l Me di cine (AAOM) 66th Ann ual Me eti ng at Charleston/South Carolina, 17–21 April 2012. Peer review under responsibility of King Saud University. Production and hosting by Elsevier The Saudi Dental Journal (2013) 25, 43–47 King Saud University The Saudi Dental Journal www.ksu.edu.sa www.sciencedirect.com 1013-9052 ª 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.sdentj.2012.10.001

lip sweling kawasaki

Documents