Recurrent incomplete Kawasaki disease with small-joint-predominant arthritis during the acute phase.

Authors

Kentaro Suzuki, Soichiro Ishimaru, Yuka Mihara, Satoru Kisohara

Published in

BMJ case reports. Volume 19. Issue 9. Sep 02, 2026. Epub Sep 02, 2026.

Abstract

An adolescent boy was admitted on illness day 6 with fever and left cervical lymphadenopathy. He had been treated for complete Kawasaki disease (KD) approximately a decade earlier. He subsequently developed painful swelling of the left wrist and bilateral finger and toe interphalangeal joints, impairing grip strength; ultrasonography confirmed synovitis. Although fever resolved by illness day 12, arthritis persisted. New conjunctival injection, lip erythema and a secondary rise in C-reactive protein led to a diagnosis of incomplete KD on illness day 18, followed by intravenous immunoglobulin. Arthritis rapidly improved and he was discharged without residual joint symptoms or coronary artery abnormalities. KD-associated arthritis may vary by disease phase, with acute-phase polyarthritis sometimes involving small joints and later arthritis affecting larger joints. Distinguishing this presentation from systemic juvenile idiopathic arthritis can be challenging; serial reassessment of the clinical course and treatment response is essential.

PMID:
42697565
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.

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