Coronary Artery Aneurysms After Adult-Onset Kawasaki Disease

In May 2012, we encountered a rare case of adult-onset Kawasaki disease (KD) with coronary artery abnormalities in a 24-year-old Japanese man. The patient presented with recent-onset chest pain that occurred when he was at rest and no other symptoms. His medical history included hospitalization 2 years before the present admission, at another hospital, because of a fever of unknown origin that lasted for 2 weeks, accompanied by polymorphic exanthema, cervical lymphadenopathy, nonpurulent conjunctivitis, strawberry tongue, and fingertip desquamation. At that time, the patient was diagnosed with adult-onset Still’s disease. On the basis of that diagnosis, he was treated with steroid pulse therapy alone, and his symptoms were alleviated. After 2 months, he received oral steroid therapy and was assumed to have been treated successfully; however, the patient was admitted to our hospital 20 months after concluding the oral steroid therapy.On admission to our hospital, KD was suspected because of his past history of “strawberry tongue,” which is …