PMID- 32631771 OWN - NLM STAT- MEDLINE DCOM- 20201222 LR - 20210110 IS - 1532-8171 (Electronic) IS - 0735-6757 (Print) IS - 0735-6757 (Linking) VI - 39 DP - 2021 Jan TI - COVID-19 associated Kawasaki-like multisystem inflammatory disease in an adult. PG - 253.e1-253.e2 LID - S0735-6757(20)30542-8 [pii] LID - 10.1016/j.ajem.2020.06.053 [doi] AB - Recent reports have described a secondary Multisystem Inflammatory Syndrome in Children (MIS-C) after a prior COVID-19 infection that often has features of Kawasaki disease (KD). Here, we report the case of a 36-year-old woman who presented to the emergency department hypotensive and tachycardic after 1 week of fevers, abdominal pain, vomiting and diarrhea, and was found to have the classic phenotype of complete Kawasaki's Disease including nonexudative conjunctivitis, cracked lips, edema of the hands and feet, palmar erythema, a diffuse maculopapular rash, and cervical lymphadenopathy. Initial laboratory studies were significant for hyponatremia, elevated liver function tests including direct hyperbilirubinemia, and leukocytosis with neutrophilia. Imaging revealed mild gallbladder wall edema, a small area of colitis, and small pleural effusion. She was treated for Kawasaki Disease Shock Syndrome (KDSS) with pulse dose solumedrol, IVIG, and aspirin with near resolution of symptoms and normalization of vital signs within 1 day and subsequent improvement in her laboratory abnormalities. She was later found to be COVID-19 IgG positive, suggesting past exposure. This case represents an early report of a KD-like illness in an adult with serologic evidence of a previous COVID-19 infection, similar to MIS-C. It suggests that the virulent strain of SARS-CoV-2 appears to cause a post-infectious inflammatory syndrome similar to KD in adults, as well as children. Our understanding of the myriad of COVID-19 symptoms and sequelae is rapidly evolving. We recommend physicians remain vigilant for inflammatory syndromes that mimic KD/KDSS which may warrant prompt treatment with IVIG and steroids. CI - Copyright (c) 2020 Elsevier Inc. All rights reserved. FAU - Sokolovsky, Sabrina AU - Sokolovsky S AD - Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, United States of America. FAU - Soni, Parita AU - Soni P AD - Division of Pulmonary and Critical Care, Maimonides Medical Center, Brooklyn, NY, United States of America. FAU - Hoffman, Taryn AU - Hoffman T AD - Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, United States of America. FAU - Kahn, Philip AU - Kahn P AD - Division of Pediatric Rheumatology, New York University Langone Medical Center, New York, NY, United States of America. FAU - Scheers-Masters, Joshua AU - Scheers-Masters J AD - Division of Rheumatology, Maimonides Medical Center, Brooklyn, NY, United States of America. Electronic address: JScheers-Masters@maimonidesmed.org. LA - eng PT - Case Reports DEP - 20200625 PL - United States TA - Am J Emerg Med JT - The American journal of emergency medicine JID - 8309942 SB - IM MH - Adult MH - COVID-19/complications/*diagnosis MH - Diagnosis, Differential MH - Female MH - Humans MH - Mucocutaneous Lymph Node Syndrome MH - Systemic Inflammatory Response Syndrome/*virology PMC - PMC7315983 OTO - NOTNLM OT - COVID-19 OT - Kawasaki Disease Shock Syndrome OT - Kawasaki disease OT - Multisystem Inflammatory Syndrome EDAT- 2020/07/08 06:00 MHDA- 2020/12/23 06:00 PMCR- 2020/06/25 CRDT- 2020/07/08 06:00 PHST- 2020/06/07 00:00 [received] PHST- 2020/06/18 00:00 [accepted] PHST- 2020/07/08 06:00 [pubmed] PHST- 2020/12/23 06:00 [medline] PHST- 2020/07/08 06:00 [entrez] PHST- 2020/06/25 00:00 [pmc-release] AID - S0735-6757(20)30542-8 [pii] AID - 10.1016/j.ajem.2020.06.053 [doi] PST - ppublish SO - Am J Emerg Med. 2021 Jan;39:253.e1-253.e2. doi: 10.1016/j.ajem.2020.06.053. Epub 2020 Jun 25.