title: Abdominal lymphadenopathy in an adolescent with Kawasaki disease: a major sign?
abstract: In adolescence, Kawasaki disease (KD) may present with varied clinical pictures, and the classic clinical criteria are often insufficient to establish the diagnosis. This report presents a clinical case of KD in an adolescent and a brief review of the relevant literature, based on a PubMed search using the terms "adolescence" and "KD". A 13-year-old girl presented with fever, rash, hepatomegaly, and ultrasonographic evidence of abdominal lymphadenopathy. On week 2 after onset of symptoms, the patient developed desquamation of the extremities and thrombocytosis. Echocardiography was normal during the acute illness and remained unchanged at 2-year follow-up. Clinicians should be aware that, in adolescents, KD poses a diagnostic challenge and rarely corresponds to the classic presentation. On retrospective analysis, we believe that abdominal lymphadenopathy should have been recognized as a substitute manifestation of the classic symptom of cervical lymphadenopathy to establish the diagnosis of this fearsome systemic vasculitis syndrome.
authors.affiliation: .
authors.forename: Danielle
authors.initials: D
authors.lastname: Bulkool
authors.affiliation: .
authors.forename: Ana Vidal
authors.initials: AV
authors.lastname: de Carvalho
authors.affiliation: .
authors.forename: Aurea
authors.initials: A
authors.lastname: Grippa
authors.affiliation: .
authors.forename: Marcia
authors.initials: M
authors.lastname: Fernandes
authors.affiliation: .
authors.forename: Israel
authors.identifier: http://orcid.org/0000-0002-2054-0739
authors.initials: I
authors.lastname: Figueiredo
mesh_terms: D000005:Abdomen; D000293:Adolescent; D005260:Female; D006801:Humans; D000072281:Lymphadenopathy / Q000209:etiology*; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000175:diagnosis*
keywords: Kawasaki disease; abdominal pain; adolescent; intestinal lymph node; jaundice; mesenteric lymphadenitis; rash